eprintid: 27044
rev_number: 12
eprint_status: archive
userid: 1249
dir: disk0/00/02/70/44
datestamp: 2019-09-04 09:27:16
lastmod: 2020-02-19 07:59:53
status_changed: 2019-09-04 09:27:16
type: article
metadata_visibility: show
creators_name: Steiner, Thorsten
creators_name: Juvela, Seppo
creators_name: Unterberg, Andreas
creators_name: Jung, Carla
creators_name: Forsting, Michael
creators_name: Rinkel, Gabriel
title: European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage
subjects: 610
divisions: 911100
note: Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich.

This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
abstract: Background: Intracranial aneurysm with and without subarachnoid haemorrhage (SAH) is a relevant health problem: The overall incidence is about 9 per 100,000 with a wide range, in some countries up to 20 per 100,000. Mortality rate with conservative treatment within the first months is 50–60%. About one third of patients left with an untreated aneurysm will die from recurrent bleeding within 6 months after recovering from the first bleeding. The prognosis is further influenced by vasospasm, hydrocephalus, delayed ischaemic deficit and other complications. The aim of these guidelines is to provide comprehensive recommendations on the management of SAH with and without aneurysm as well as on unruptured intracranial aneurysm. Methods: We performed an extensive literature search from 1960 to 2011 using Medline and Embase. Members of the writing group met in person and by teleconferences to discuss recommendations. Search results were graded according to the criteria of the European Federation of Neurological Societies. Members of the Guidelines Committee of the European Stroke Organization reviewed the guidelines. Results: These guidelines provide evidence-based information on epidemiology, risk factors and prognosis of SAH and recommendations on diagnostic and therapeutic methods of both ruptured and unruptured intracranial aneurysms. Several risk factors of aneurysm growth and rupture have been identified. We provide recommendations on diagnostic work up, monitoring and general management (blood pressure, blood glucose, temperature, thromboprophylaxis, antiepileptic treatment, use of steroids). Specific therapeutic interventions consider timing of procedures, clipping and coiling. Complications such as hydrocephalus, vasospasm and delayed ischaemic deficit were covered. We also thought to add recommendations on SAH without aneurysm and on unruptured aneurysms. Conclusion: Ruptured intracranial aneurysm with a high rate of subsequent complications is a serious disease needing prompt treatment in centres having high quality of experience of treatment for these patients. These guidelines provide practical, evidence-based advice for the management of patients with intracranial aneurysm with or without rupture. Applying these measures can improve the prognosis of SAH.
date: 2013
publisher: S. Karger
id_scheme: DOI
official_url: https://doi.org/10.1159/000346087
ppn_swb: 1678033499
own_urn: urn:nbn:de:bsz:16-heidok-270444
language: eng
bibsort: STEINERTHOEUROPEANST2013
full_text_status: public
publication: Cerebrovascular Diseases
volume: 35
number: 2
pagerange: 93-112
issn: 1015-9770
citation:   Steiner, Thorsten ; Juvela, Seppo ; Unterberg, Andreas ; Jung, Carla ; Forsting, Michael ; Rinkel, Gabriel  (2013) European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage.  Cerebrovascular Diseases, 35 (2).  pp. 93-112.  ISSN 1015-9770     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/27044/1/346087.pdf