Subarachnoid haemorrhage (SAH) is a relevant health problem with an approximate incidence of 9 per 100,000 and a mortality rate of about 60% within 6 months. Applying these measures can improve the prognosis of SAH. These guidelines provide practical, evidence-based advice for the management of patients with intracranial aneurysm with or without rupture. 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. We also thought to add recommendations on SAH without aneurysm and on unruptured aneurysms. Complications such as hydrocephalus, vasospasm and delayed ischaemic deficit were covered. Specific therapeutic interventions consider timing of procedures, clipping and coiling. We provide recommendations on diagnostic work up, monitoring and general management (blood pressure, blood glucose, temperature, thromboprophylaxis, antiepileptic treatment, use of steroids). Several risk factors of aneurysm growth and rupture have been identified. 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. Members of the Guidelines Committee of the European Stroke Organization reviewed the guidelines. Search results were graded according to the criteria of the European Federation of Neurological Societies. Members of the writing group met in person and by teleconferences to discuss recommendations. Methods: We performed an extensive literature search from 1960 to 2011 using Medline and Embase. 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. The prognosis is further influenced by vasospasm, hydrocephalus, delayed ischaemic deficit and other complications. About one third of patients left with an untreated aneurysm will die from recurrent bleeding within 6 months after recovering from the first bleeding. Mortality rate with conservative treatment within the first months is 50–60%. 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.
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