Curriculum Resources


Neurointensive Care - Capability Levels and Curriculum Reference for Stages 1-3

Subarachnoid Haemorrhage & Anaesthesia for Neurovascular Surgery

Published on 18 March, 2022

Last modified on March 18th, 2024

Curriculum Reference

13.11.7 Manages the resuscitation, stabilisation and transfer of patients with acute neurological deterioration.

15.9.2 Delivers safe peri-operative anaesthetic care to adults for emergency intracranial surgery, CSF diversions, spinal surgery and endovascular thrombectomy.

15.9.2 Delivers safe anaesthetic care for neuro-radiological investigations and interventions such as coiling, embolisation and endovascular thrombectomy.

HiLLO 12: Doctors specialising in Intensive Care Medicine understand the special needs of, and are competent to manage patients with neurological diseases, both medical and those requiring surgery, which will include the management of raised intracranial pressure, central nervous system infections and neuromuscular disorders.

Review Articles

Delayed cerebral ischaemia after subarachnoid haemorrhage: looking beyond vasospasm

Link below to review article from 2016 “The critical care management of poor-grade subarachnoid haemorrhage”

https://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1193-9

Pathophysiology of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: A Review

Perioperative management of hydrocephalus BJA Education 18(5) 140-146 (2018)

Perioperative Management of Aneurysmal Subarachnoid Hemorrhage

BJA Education 18(10) 291-299 (2018)

Further Reading (incl. Key Trials)

Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial.

International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial

Cerebral arterial spasm-a controlled trial of nimodipine in patients with subarachnoid haemorrhage

Link to Pub med for “Clazosentan, an endothelin receptor antagonist, in patients with aneurysmal subarachnoid haemorrhage undergoing surgical clipping: a randomised, double-blind, placebo-controlled phase 3 trial (CONSCIOUS-2)” below

https://pubmed.ncbi.nlm.nih.gov/21640651/

Endocrine dysregulation in aneurysmal subarachnoid haemorrhage

mild hypothermia during clipping 2005 trial

https://www.nejm.org/doi/full/10.1056/NEJMoa040975

Tranexamic acid for SAH – 1984

https://pubmed.ncbi.nlm.nih.gov/6379455/

National Guidance/Standards

New 2023 guidlines

2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association (ahajournals.org)

AHA/ASA Guidelines for the management of aneurysmal subarachnoid haemorrhage

European Stroke Organisation Guidelines

(Draft) NICE Guideline for Subarachnoid Haemorrhage

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

e-learning

Anaesthesia (e-LA) – Acute management of aneurysmal subarachnoid haemorrhage

Online Resources

Life in the Fast Lane (LITFL)

Anesthesia for intracranial neurovascular procedures in adults – UpToDate (paywall)

RCoA Audit Compendium

12.3 Subarachnoid haemorrhage

NACCS Webinars & Video

Anaesthesia for clipping of intracerebral aneurysm Dr Adapa
3/9/2016 14.00 anaemia and transfusion after SAH

Upcoming live events

Neurovascular surgery in the endovascular era, May 10th Birmingham NACCS ASM

https://whova.com/embedded/session/PNpy+n+0R1uFaYxRcA0L208W1G1OT4u0nlGcVXsZr5w=/2121915/?widget=primary

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