{
  "schemaVersion": 2,
  "eyebrow": "Neurocritical Care",
  "title": "Subarachnoid Hemorrhage",
  "summary": "Spontaneous subarachnoid hemorrhage requires immediate noncontrast CT, escalation to lumbar puncture when suspicion persists after negative imaging, identification and early exclusion of an aneurysm, specialized neurovascular care, and prevention of delayed cerebral ischemia with nimodipine and vigilant vasospasm surveillance. [7]",
  "seoDescription": "Point-of-care review of subarachnoid hemorrhage diagnosis, aneurysm evaluation, early neurovascular management, and prevention of delayed cerebral ischemia.",
  "clinicalQuestion": "How should physicians rapidly diagnose and manage suspected spontaneous subarachnoid hemorrhage while preventing rebleeding and delayed cerebral ischemia?",
  "specialty": "Neurology and Neurocritical Care",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "subarachnoid hemorrhage",
    "aneurysmal subarachnoid hemorrhage",
    "thunderclap headache",
    "nimodipine",
    "vasospasm",
    "delayed cerebral ischemia"
  ],
  "keyTakeaways": [
    "In suspected spontaneous subarachnoid hemorrhage, noncontrast head CT is the initial diagnostic study; if CT is negative but clinical suspicion remains, perform lumbar puncture. [7]",
    "Aneurysmal subarachnoid hemorrhage should be managed in a specialized center with early aneurysm exclusion from the circulation. [7]",
    "Nimodipine is recommended to prevent delayed cerebral ischemia after subarachnoid hemorrhage. [7]",
    "Transcranial Doppler ultrasonography is useful for diagnosing and monitoring vasospasm, but clinical deterioration requires broader evaluation for delayed cerebral ischemia and alternative causes. [7]",
    "Hypertension and smoking are major risk factors for spontaneous aneurysmal subarachnoid hemorrhage. [7]"
  ],
  "sections": [
    {
      "id": "initial-diagnostic-pathway",
      "eyebrow": "Immediate evaluation",
      "heading": "Diagnose suspected subarachnoid hemorrhage without delaying definitive care",
      "intro": "Treat a compatible presentation as a neurovascular emergency until excluded.",
      "paragraphs": [
        "Obtain noncontrast head CT first in suspected spontaneous subarachnoid hemorrhage. If CT does not demonstrate hemorrhage but the clinical suspicion remains high, proceed to lumbar puncture. This sequence is identified as the diagnostic approach of choice in the supplied guideline. [7]",
        "After subarachnoid hemorrhage is confirmed, diagnostic evaluation must identify the bleeding source, most commonly a ruptured cerebral aneurysm. The guideline identifies MRI and angiography as studies used to determine the source of hemorrhage. [7]",
        "Diagnostic workup should proceed in parallel with stabilization and transfer planning. Patients with subarachnoid hemorrhage require care in specialized centers experienced in neurovascular diagnosis, intervention, and complication management. [7]"
      ],
      "bullets": [
        "Initial test: noncontrast head CT. [7]",
        "Persisting suspicion after negative CT: lumbar puncture. [7]",
        "Source evaluation after confirmation: angiography and MRI are cited diagnostic modalities. [7]",
        "Disposition: specialized neurovascular/stroke center care. [7]"
      ],
      "subsections": [],
      "table": {
        "caption": "Diagnostic sequence for suspected spontaneous subarachnoid hemorrhage. [7]",
        "columns": [
          "Clinical state",
          "Immediate action",
          "Decision consequence"
        ],
        "rows": [
          [
            "Suspected spontaneous subarachnoid hemorrhage",
            "Noncontrast head CT. [7]",
            "Confirms hemorrhage when positive and initiates source evaluation and urgent neurovascular management. [7]"
          ],
          [
            "Negative CT with persistent clinical suspicion",
            "Lumbar puncture. [7]",
            "Used to evaluate for subarachnoid hemorrhage not demonstrated on CT. [7]"
          ],
          [
            "Confirmed subarachnoid hemorrhage",
            "MRI and angiography to determine the bleeding source. [7]",
            "Supports identification and early exclusion of a ruptured aneurysm from the circulation. [7]"
          ]
        ]
      }
    },
    {
      "id": "early-management",
      "eyebrow": "First hours",
      "heading": "Stabilize and secure the aneurysm early",
      "intro": "The immediate priorities are neurologic stabilization, prevention of rebleeding, and prompt neurovascular intervention.",
      "paragraphs": [
        "Subarachnoid hemorrhage is a severe, complex condition that should be managed in a specialized center. Early exclusion of an aneurysm from the circulation is recommended. [7]",
        "Initial neurologic severity stratification informs level of care. The supplied guideline advises considering stroke-unit admission for patients with good initial clinical condition, specifically Hunt and Hess grades I or II; more severe presentations require higher-acuity monitoring and neurocritical care capability. [7]",
        "Blood pressure treatment may be considered in the management of vasospasm, but the supplied source does not provide a general acute blood-pressure target before aneurysm exclusion. Use institutional neurovascular protocols and avoid implying a specific threshold unsupported by the available evidence. [7]"
      ],
      "bullets": [
        "Arrange early neurosurgical and endovascular consultation for aneurysm exclusion. [7]",
        "Use a specialized neurovascular center or transfer pathway when local capability is unavailable. [7]",
        "Use Hunt and Hess grading to communicate initial clinical condition and support disposition decisions. [7]",
        "Do not delay escalation of care while awaiting complete etiologic characterization. [7]"
      ],
      "subsections": [
        {
          "heading": "Treatment modality selection",
          "paragraphs": [
            "The supplied guideline recommends early aneurysm exclusion but does not provide source-supported comparative criteria for surgical clipping versus endovascular coiling. Procedure selection should therefore be made by the neurovascular team according to aneurysm anatomy, patient status, and local expertise rather than applying unsupported universal rules. [7]"
          ],
          "bullets": []
        }
      ],
      "table": {
        "caption": "Early management priorities in spontaneous subarachnoid hemorrhage. [7]",
        "columns": [
          "Priority",
          "Action",
          "Rationale"
        ],
        "rows": [
          [
            "Appropriate setting",
            "Manage in a specialized center. [7]",
            "Subarachnoid hemorrhage requires experienced diagnostic, neurocritical care, and neurovascular treatment pathways. [7]"
          ],
          [
            "Prevent recurrent aneurysmal bleeding",
            "Pursue early exclusion of the aneurysm from the circulation. [7]",
            "Ruptured aneurysm is the most common cause of spontaneous subarachnoid hemorrhage. [7]"
          ],
          [
            "Severity communication",
            "Document clinical grade, including Hunt and Hess status. [7]",
            "Initial condition informs monitoring intensity and disposition. [7]"
          ]
        ]
      }
    },
    {
      "id": "delayed-cerebral-ischemia",
      "eyebrow": "Days after hemorrhage",
      "heading": "Prevent and monitor delayed cerebral ischemia",
      "intro": "Delayed cerebral ischemia and vasospasm require active surveillance after aneurysm-directed treatment.",
      "paragraphs": [
        "Nimodipine is recommended for prevention of delayed cerebral ischemia after subarachnoid hemorrhage. [7] The supplied literature does not provide a dosing regimen, route, duration, contraindications, or monitoring parameters; use current institutional protocols and product labeling for these details.",
        "Transcranial Doppler ultrasonography is useful for diagnosing and monitoring vasospasm. [7] It should be interpreted in the clinical context rather than treated as a stand-alone determinant of cerebral ischemia.",
        "For established or refractory vasospasm, the guideline states that blood pressure treatment and neurovascular intervention may be considered. [7] The source does not specify an induced-hypertension target, endovascular technique, or intervention threshold; these decisions require individualized neurocritical care and neurointerventional assessment."
      ],
      "bullets": [
        "Administer nimodipine for delayed cerebral ischemia prevention. [7]",
        "Monitor for vasospasm with transcranial Doppler ultrasonography. [7]",
        "Evaluate new focal deficits or reduced consciousness urgently for delayed cerebral ischemia, vasospasm, rebleeding, hydrocephalus, seizure, metabolic derangement, and nonneurologic critical illness; the supplied source specifically supports Doppler monitoring for vasospasm but does not provide a complete differential algorithm. [7]",
        "Consider blood pressure treatment and neurovascular intervention for refractory vasospasm according to specialist assessment. [7]"
      ],
      "subsections": [],
      "table": {
        "caption": "Monitoring and escalation for vasospasm and delayed cerebral ischemia after subarachnoid hemorrhage. [7]",
        "columns": [
          "Problem",
          "Supported monitoring or treatment",
          "Important limitation"
        ],
        "rows": [
          [
            "Delayed cerebral ischemia prevention",
            "Nimodipine is recommended. [7]",
            "No source-supported dose or duration is available in the supplied literature."
          ],
          [
            "Vasospasm surveillance",
            "Transcranial Doppler ultrasonography is useful for diagnosis and monitoring. [7]",
            "Doppler findings require correlation with examination and other clinical data."
          ],
          [
            "Refractory vasospasm",
            "Blood pressure treatment and neurovascular intervention may be considered. [7]",
            "No specific target or procedural selection criteria are provided in the supplied source."
          ]
        ]
      }
    },
    {
      "id": "risk-and-prognosis",
      "eyebrow": "Counseling and risk",
      "heading": "Frame risk, prognosis, and prevention around modifiable factors",
      "intro": "Risk-factor modification matters, but acute prognosis is driven chiefly by hemorrhage severity and complications.",
      "paragraphs": [
        "Rupture of a cerebral aneurysm is the most common cause of spontaneous subarachnoid hemorrhage. Hypertension and smoking are identified as the principal risk factors. [7] These factors should be addressed in long-term prevention discussions after stabilization.",
        "Clinical condition at presentation is central to prognosis and care intensity. The supplied guideline uses Hunt and Hess grades I and II to identify patients with good initial clinical condition who may be considered for stroke-unit admission. [7] It does not provide source-supported mortality estimates, rebleeding probabilities, or validated treatment-specific prognostic thresholds.",
        "Avoid overinterpreting hemorrhage severity from a single variable. The available source supports clinical grading and specialized-center care but does not provide a complete prognostic model or a specific framework for goals-of-care decisions. [7]"
      ],
      "bullets": [
        "Address smoking cessation and hypertension management during recovery and secondary prevention planning. [7]",
        "Use initial neurologic grade to communicate severity, allocate monitoring resources, and structure prognostic discussions. [7]",
        "Explain that aneurysm-directed treatment and delayed ischemia prevention remain time-sensitive even in initially good-grade disease. [7]"
      ],
      "subsections": [],
      "table": {
        "caption": "Risk and prognostic factors supported by the supplied literature. [7]",
        "columns": [
          "Factor",
          "Clinical implication"
        ],
        "rows": [
          [
            "Hypertension",
            "Major risk factor for spontaneous subarachnoid hemorrhage; address as part of long-term prevention. [7]"
          ],
          [
            "Smoking",
            "Major risk factor for spontaneous subarachnoid hemorrhage; cessation counseling is clinically relevant after stabilization. [7]"
          ],
          [
            "Initial Hunt and Hess clinical condition",
            "Supports acuity stratification and disposition planning; grades I–II are described as good initial clinical condition. [7]"
          ]
        ]
      }
    },
    {
      "id": "care-delivery",
      "eyebrow": "Systems of care",
      "heading": "Use a protocolized multidisciplinary pathway",
      "intro": "Time-sensitive diagnosis, aneurysm treatment, and complication surveillance depend on coordinated systems.",
      "paragraphs": [
        "The supplied guideline emphasizes care in specialized centers and early aneurysm exclusion. [7] A practical U.S. pathway should therefore include emergency medicine, neurology, neurosurgery, neurointerventional specialists, anesthesia, neurocritical care, and transfer coordination when local definitive treatment is unavailable.",
        "Use structured handoffs that include time of symptom onset, neurologic examination, CT result, lumbar-puncture result when obtained, hemodynamic trajectory, antithrombotic exposure, and timing of neurovascular consultation. These elements are operationally important, although specific handoff content is not prescribed in the supplied literature."
      ],
      "bullets": [
        "Activate transfer early if angiography, aneurysm treatment, neurocritical care, or endovascular rescue capability is unavailable. [7]",
        "Ensure the receiving center can provide early aneurysm exclusion and monitoring for vasospasm and delayed cerebral ischemia. [7]",
        "Embed transcranial Doppler capability within the post-hemorrhage surveillance pathway when available. [7]"
      ],
      "subsections": [],
      "table": {
        "caption": "Core components of a subarachnoid hemorrhage care pathway. [7]",
        "columns": [
          "Phase",
          "System requirement"
        ],
        "rows": [
          [
            "Diagnosis",
            "Immediate noncontrast CT and lumbar puncture when CT is negative but suspicion persists. [7]"
          ],
          [
            "Etiologic evaluation",
            "Access to angiography and neurovascular expertise to identify the bleeding source. [7]"
          ],
          [
            "Definitive treatment",
            "Early aneurysm exclusion at a specialized center. [7]"
          ],
          [
            "Post-treatment surveillance",
            "Nimodipine use and transcranial Doppler monitoring for delayed cerebral ischemia and vasospasm. [7]"
          ]
        ]
      }
    }
  ],
  "faq": [
    {
      "question": "What should follow a negative noncontrast CT when suspicion for subarachnoid hemorrhage remains high?",
      "answer": "Perform lumbar puncture when CT is negative but clinical suspicion for subarachnoid hemorrhage persists. [7]"
    },
    {
      "question": "What medication is recommended to prevent delayed cerebral ischemia after subarachnoid hemorrhage?",
      "answer": "Nimodipine is recommended for prevention of delayed cerebral ischemia. The supplied source does not provide dosing details. [7]"
    },
    {
      "question": "How should vasospasm be monitored after subarachnoid hemorrhage?",
      "answer": "Transcranial Doppler ultrasonography is useful for diagnosing and monitoring vasospasm. [7]"
    },
    {
      "question": "Where should patients with aneurysmal subarachnoid hemorrhage be treated?",
      "answer": "Manage patients in a specialized center capable of early aneurysm exclusion and neurovascular complication management. [7]"
    }
  ],
  "references": [
    {
      "number": 1,
      "title": "UK guidelines on the management of variceal ...",
      "detail": "gut.bmj.com",
      "url": "https://gut.bmj.com/content/64/11/1680",
      "authors": "gut.bmj.com",
      "host": "gut.bmj.com"
    },
    {
      "number": 2,
      "title": "A Pooled Analysis of INTERACT2 and ATACH II",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.125.049096",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 3,
      "title": "Cerebral Hemorrhage: Pathophysiology, Treatment, and ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.121.319949",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 4,
      "title": "Volume Tolerance and Prognostic Impact of Hematoma ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/STROKEAHA.124.049008",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 5,
      "title": "2022 Guideline for the Management of Patients With ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/STR.0000000000000407",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org"
    },
    {
      "number": 6,
      "title": "FDA-approved heterocyclic molecules for cancer treatment",
      "detail": "www.cell.com",
      "url": "https://www.cell.com/heliyon/fulltext/S2405-8440(23)10380-X",
      "authors": "www.cell.com",
      "host": "www.cell.com"
    },
    {
      "number": 7,
      "title": "Clinical management guidelines for subarachnoid haemorrhage. Diagnosis and treatment",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2173580814000819",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 8,
      "title": "Control of Hemorrhage - an overview",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/control-of-hemorrhage",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 9,
      "title": "Perioperative management of brain hemorrhage: Advances in anesthetic strategies and translational medicine",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2589238X25000555",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 10,
      "title": "Management of Intracerebral Hemorrhage: JACC Focus ...",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0735109720344922",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com"
    },
    {
      "number": 11,
      "title": "The FDA's Generic-Drug Approval Process:... : American Journal of Gastroenterology",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ajg/fulltext/10.1038/ajg.2011.29~the-fdas-generic-drug-approval-process-similarities-to-and",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 12,
      "title": "Prescribing patterns of target-specific oral... : Blood Coagulation & Fibrinolysis",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/bloodcoagulation/fulltext/2015/10000/prescribing_patterns_of_target_specific_oral.9.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com"
    },
    {
      "number": 13,
      "title": "Stop the bleed “ – Prehospital bleeding control in patients with multiple and/or severe injuries – A systematic review and clinical practice guideline – A systematic review and clinical practice guideline",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11799122",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 14,
      "title": "Management of obstetric and gynecologic hemorrhage: a narrative review of current guidelines and evidence",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13155169",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 15,
      "title": "Nonsurgical management of major hemorrhage - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10241541",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 16,
      "title": "National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5161642",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov"
    },
    {
      "number": 17,
      "title": "Clinical guideline highlights for the hospitalist",
      "detail": "pubmed.ncbi.nlm.nih.gov",
      "url": "https://pubmed.ncbi.nlm.nih.gov/36725674",
      "authors": "pubmed.ncbi.nlm.nih.gov",
      "host": "pubmed.ncbi.nlm.nih.gov"
    },
    {
      "number": 18,
      "title": "a guideline for healthcare professionals from the ... - PubMed",
      "detail": "pubmed.ncbi.nlm.nih.gov",
      "url": "https://pubmed.ncbi.nlm.nih.gov/20651276",
      "authors": "pubmed.ncbi.nlm.nih.gov",
      "host": "pubmed.ncbi.nlm.nih.gov"
    },
    {
      "number": 19,
      "title": "Control of haemorrhage in hospital - Major Trauma: Assessment and Initial Management - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK368079",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 20,
      "title": "Executive Summary - Prehospital Emergency Medical Services Blood Transfusion and Fluid Interventions for Hemorrhagic Shock - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK621890",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 21,
      "title": "Hemorrhage Control - StatPearls - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/sites/books/NBK535393",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 22,
      "title": "Recommendations and supporting evidence - Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK619233",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov"
    },
    {
      "number": 23,
      "title": "Alternatives to the Kleihauer Betke test: diagnostic performance of three methods in the detection of feto-maternal hemorrhage",
      "detail": "www.ajog.org",
      "url": "https://www.ajog.org/article/S0002-9378(03)01415-7/fulltext",
      "authors": "www.ajog.org",
      "host": "www.ajog.org"
    },
    {
      "number": 24,
      "title": "Investigation of Acute Idiopathic Pulmonary Hemorrhage ...",
      "detail": "www.cdc.gov",
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5335a4.htm",
      "authors": "www.cdc.gov",
      "host": "www.cdc.gov"
    }
  ],
  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
    {
      "number": 1,
      "title": "UK guidelines on the management of variceal ...",
      "detail": "gut.bmj.com",
      "url": "https://gut.bmj.com/content/64/11/1680",
      "authors": "gut.bmj.com",
      "host": "gut.bmj.com",
      "snippet": "section. Coauthor of section ‘Management of active variceal haemorrhage’. Review of entire guideline. HM: consultant interventional radiologist, University Hospitals Birmingham. Coauthor of sections ‘Service delivery and development’ and ‘Management of active variceal haemorrhage’ in relation to TIP",
      "score": 0.3510001
    },
    {
      "number": 2,
      "title": "A Pooled Analysis of INTERACT2 and ATACH II",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/JAHA.125.049096",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by V Brissette · 2026 — Our findings indicate that the optimal final hematoma volume thresholds associated with poor prognosis are 8.1 mL for thalamic ICH and 22.0 mL",
      "score": 0.55362654
    },
    {
      "number": 3,
      "title": "Cerebral Hemorrhage: Pathophysiology, Treatment, and ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.121.319949",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by J Magid-Bernstein · 2022 · Cited by 833 — These thresholds support a broad therapeutic window for intervention for favorable functional outcome and survival. The question of timing",
      "score": 0.3620219
    },
    {
      "number": 4,
      "title": "Volume Tolerance and Prognostic Impact of Hematoma ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/STROKEAHA.124.049008",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by A Morotti · 2025 · Cited by 25 — The optimal final ICH volume cutoff for identification of patients with poor prognosis was ≥36 mL for lobar ICH (sensitivity, 0.64; specificity",
      "score": 0.27288523
    },
    {
      "number": 5,
      "title": "2022 Guideline for the Management of Patients With ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/STR.0000000000000407",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by SM Greenberg · 2022 · Cited by 1948 — Which factors influence decisions to transfer and treat patients with acute intracerebral haemorrhage and which are associated with prognosis?",
      "score": 0.19678025
    },
    {
      "number": 6,
      "title": "FDA-approved heterocyclic molecules for cancer treatment",
      "detail": "www.cell.com",
      "url": "https://www.cell.com/heliyon/fulltext/S2405-8440(23)10380-X",
      "authors": "www.cell.com",
      "host": "www.cell.com",
      "snippet": "by M Hossain · 2024 · Cited by 71 — 200 mg of TUKYSA is recommended to intake orally daily two times for the patients who are suffering from severe hepatic impairment [38].",
      "score": 0.0840483
    },
    {
      "number": 7,
      "title": "Clinical management guidelines for subarachnoid haemorrhage. Diagnosis and treatment",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2173580814000819",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "The diagnostic tests recommended in order to determine the source of the haemorrhage are MRI (magnetic resonance imaging) and angiography. Doppler ultrasonography studies are very useful for diagnosing and monitoring vasospasm. Nimodipine is recommended for preventing delayed cerebral ischaemia. Blo",
      "score": 0.59033114
    },
    {
      "number": 8,
      "title": "Control of Hemorrhage - an overview",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/control-of-hemorrhage",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "2021, International Journal of Obstetric AnesthesiaB.D. Einerson, C.F. Weiniger\n\n### Hemorrhage management and monitoring\n\n#### Prevention and management of hemorrhage\n\nDue to lack of robust evidence, recommendations for hemorrhage management come primarily from expert opinion and consensus statemen",
      "score": 0.5005133
    },
    {
      "number": 9,
      "title": "Perioperative management of brain hemorrhage: Advances in anesthetic strategies and translational medicine",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2589238X25000555",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "monitoring, guides intraoperative decision-making. Postoperative complications such as rebleeding, vasospasm, and seizures require vigilant monitoring and management. Translational research has identified promising neuroprotective effects of anesthetic agents in animal models, but clinical translati",
      "score": 0.45289946
    },
    {
      "number": 10,
      "title": "Management of Intracerebral Hemorrhage: JACC Focus ...",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S0735109720344922",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "by M Schrag · 2020 · Cited by 297 — Modern treatment of ICH focuses on rapid stabilization, often requiring urgent treatment of mass effect, aggressive blood pressure reduction",
      "score": 0.14991707
    },
    {
      "number": 11,
      "title": "The FDA's Generic-Drug Approval Process:... : American Journal of Gastroenterology",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/ajg/fulltext/10.1038/ajg.2011.29~the-fdas-generic-drug-approval-process-similarities-to-and",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Copyright © 2026 Wolters Kluwer N.V. and/or its subsidiaries or third-party licensors. All rights reserved, including those for text and data mining and artificial intelligence training. For all open access content, the relevant licensing terms apply.\n\n## Your Privacy\n\nTo give you the best possible ",
      "score": 0.108387195
    },
    {
      "number": 12,
      "title": "Prescribing patterns of target-specific oral... : Blood Coagulation & Fibrinolysis",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/bloodcoagulation/fulltext/2015/10000/prescribing_patterns_of_target_specific_oral.9.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "oral anticoagulant prior to hospitalization. Over half (53.1%) of the patients received rivaroxaban, 43.7% received dabigatran and 3.1% received apixaban. Atrial fibrillation (68.1%) and venous thromboembolism treatment (25.6%) were the most common indications. Ninety percent of patients had a U.S. ",
      "score": 0.09342148
    },
    {
      "number": 13,
      "title": "Stop the bleed “ – Prehospital bleeding control in patients with multiple and/or severe injuries – A systematic review and clinical practice guideline – A systematic review and clinical practice guideline",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11799122",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "C) Relevance and comparability.\n\nIn clinical reality, haemorrhages are heterogeneous in terms of the amount of blood loss, the type of bleeding vessel (arterial, venous, diffuse, spurting haemorrhages), or individual factors such as the influence of anticoagulant medications on the blood’s ability t",
      "score": 0.6010557
    },
    {
      "number": 14,
      "title": "Management of obstetric and gynecologic hemorrhage: a narrative review of current guidelines and evidence",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13155169",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "Although obstetric hemorrhage represents the main focus of this review, gynecologic hemorrhage, particularly abnormal uterine bleeding (AUB), remains an important clinical entity associated with chronic morbidity, impaired quality of life, and increased healthcare utilization. Contemporary approache",
      "score": 0.44622982
    },
    {
      "number": 15,
      "title": "Nonsurgical management of major hemorrhage - PMC",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC10241541",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "| Hemorrhage situation | Suggested modification |\n --- |\n| Clinical presentation |\n| Postpartum hemorrhage |  Maintain fibrinogen > 2.0 g/L |\n| Head injury |  Maintain platelet count > 100 × 109/L |\n| Gastrointestinal bleeding |  Restrictive red cell threshold (< 70 g/L) and target (70–90 g/L)  Avoi",
      "score": 0.43180037
    },
    {
      "number": 16,
      "title": "National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review",
      "detail": "pmc.ncbi.nlm.nih.gov",
      "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC5161642",
      "authors": "pmc.ncbi.nlm.nih.gov",
      "host": "pmc.ncbi.nlm.nih.gov",
      "snippet": "It is well-recognized that peripartum blood loss is inaccurately measured, with accuracy worsening at larger volumes of blood loss.38–41 Determining whether and how blood loss measurements influence clinical practice is challenging. In a high-quality systematic review of studies that evaluated metho",
      "score": 0.42620277
    },
    {
      "number": 17,
      "title": "Clinical guideline highlights for the hospitalist",
      "detail": "pubmed.ncbi.nlm.nih.gov",
      "url": "https://pubmed.ncbi.nlm.nih.gov/36725674",
      "authors": "pubmed.ncbi.nlm.nih.gov",
      "host": "pubmed.ncbi.nlm.nih.gov",
      "snippet": "by DC Burroughs-Ray · 2023 · Cited by 18 — 2022 Guideline for the Management of Patients with Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke",
      "score": 0.39599866
    },
    {
      "number": 18,
      "title": "a guideline for healthcare professionals from the ... - PubMed",
      "detail": "pubmed.ncbi.nlm.nih.gov",
      "url": "https://pubmed.ncbi.nlm.nih.gov/20651276",
      "authors": "pubmed.ncbi.nlm.nih.gov",
      "host": "pubmed.ncbi.nlm.nih.gov",
      "snippet": "by LB Morgenstern · 2010 · Cited by 2005 — The guidelines offer a framework for goal-directed treatment of the patient with intracerebral hemorrhage. Publication types. Practice Guideline",
      "score": 0.3727797
    },
    {
      "number": 19,
      "title": "Control of haemorrhage in hospital - Major Trauma: Assessment and Initial Management - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK368079",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "|  | Although the major trauma GDG reviewed the question of whole-body CT these recommendations were developed and supported by the evidence reviews addressing the scope area on imaging in each of the four clinical guidelines:   Complex fractures: assessment and management of complex fractures (incl",
      "score": 0.32450345
    },
    {
      "number": 20,
      "title": "Executive Summary - Prehospital Emergency Medical Services Blood Transfusion and Fluid Interventions for Hemorrhagic Shock - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK621890",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "## Background and Purpose\n\nIn the United States, hemorrhagic shock is a leading cause of preventable mortality.1 Initial hemorrhage management frequently occurs in the prehospital setting, where emergency medical services (EMS) clinicians implement critical interventions. Determining what prehospita",
      "score": 0.30728576
    },
    {
      "number": 21,
      "title": "Hemorrhage Control - StatPearls - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/sites/books/NBK535393",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Significant improvements in clinical outcomes can be made by transferring knowledge from the military to civilian medicine. This article reviews some of the latest science and lessons learned to improve the care of a hemorrhaging patient.\n\n## Etiology\n\nIn 2000, the World health organization (WHO) es",
      "score": 0.2592185
    },
    {
      "number": 22,
      "title": "Recommendations and supporting evidence - Consolidated guidelines for the prevention, diagnosis and treatment of postpartum haemorrhage - NCBI Bookshelf",
      "detail": "www.ncbi.nlm.nih.gov",
      "url": "https://www.ncbi.nlm.nih.gov/books/NBK619233",
      "authors": "www.ncbi.nlm.nih.gov",
      "host": "www.ncbi.nlm.nih.gov",
      "snippet": "Warning:\nThe NCBI web site requires JavaScript to function.\nmore...\n\nU.S. flag\n\nAn official website of the United States government\n\nDot gov\n\nThe .gov means it's official.\n  \nFederal government websites often end in .gov or .mil. Before\nsharing sensitive information, make sure you're on a federal\ngo",
      "score": 0.24407052
    },
    {
      "number": 23,
      "title": "Alternatives to the Kleihauer Betke test: diagnostic performance of three methods in the detection of feto-maternal hemorrhage",
      "detail": "www.ajog.org",
      "url": "https://www.ajog.org/article/S0002-9378(03)01415-7/fulltext",
      "authors": "www.ajog.org",
      "host": "www.ajog.org",
      "snippet": "## Results\n\n63 samples were analyzed by FC, OF, and KB. Significant differences between sample means were only present at concentrations <.1% with OF (_P_<.05 ANOVA) when compared to FC and KB. All testing methods overestimated the 0.02% concentration of fetal cells. Test results from each of the th",
      "score": 0.19314773
    },
    {
      "number": 24,
      "title": "Investigation of Acute Idiopathic Pulmonary Hemorrhage ...",
      "detail": "www.cdc.gov",
      "url": "https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5335a4.htm",
      "authors": "www.cdc.gov",
      "host": "www.cdc.gov",
      "snippet": "Before a diagnosis of AIPH is made, clinicians should use tests to rule out vWD and other bleeding disorders. Reviewers of the earlier",
      "score": 0.1670151
    }
  ],
  "publishedAt": "2026-08-20T23:48:59.647388Z",
  "updatedAt": "2026-08-20T23:48:59.647388Z",
  "readingMinutes": 4,
  "slug": "subarachnoid-hemorrhage"
}