In Some Brain Bleeds, Patients Do Better at High-Volume Hospitals
Guidelines for treating 'aneurysmal subarachnoid hemorrhage' revised
Thursday, May 3, 2012
Aneurysmal subarachnoid hemorrhage occurs when a weakened blood vessel within the brain ruptures, resulting in bleeding into the space around the brain.
Death rates within a month after this type of stroke were 39 percent in hospitals admitting fewer than 10 such patients each year, compared with 27 percent in hospitals treating more than 35 of these patients, according to an association news release.
"Admission to high-volume centers has been associated with lower disability and death," said Dr. E. Sander Connolly Jr., chairman of the statement-writing group, said in the release. "While the reasons for this association are not completely clear, patients admitted to high-volume facilities have increased access to experienced cerebrovascular surgeons and endovascular specialists, as well as multidisciplinary neuro intensive-care services."
Although prevention recommendations still focus on controlling high blood pressure, avoiding cigarettes and excessive drinking, the association provided additional treatment recommendations, updating guidelines from 2009.
Among the recommendations:
- Blood pressure should be controlled to balance the risk of stroke and hypertension-related re-bleeding.
- Follow-up imaging after surgical treatment of an aneurysm should be delayed unless there is a reason it's needed sooner.
- A severe headache that develops suddenly
- Loss of consciousness
The updated guidelines appear online Thursday in the journal Stroke.
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