Postinterventional critical care management of aneurysmal subarachnoid hemorrhageDatar, Sudhir; Rabinstein, Alejandro A.Current Opinion in Critical Care: April 2017 - Volume 23 - Issue 2 - p 87–93 doi: 10.1097/MCC.0000000000000391 NEUROSCIENCE: Edited by Raimund Helbok Buy Abstract Author InformationAuthors Article MetricsMetrics Purpose of review Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects. Recent findings Growing body of evidence highlights the usefulness of CT perfusion scans in the diagnosis of vasospasm and delayed cerebral ischemia (DCI). Hypervolemia leads to worse cardiopulmonary outcomes and does not improve DCI. The traditional triple H therapy is falling out of favor with hemodynamic augmentation alone now considered the mainstay of medical management. Randomized controlled trials have shown that simvastatin and intravenous magnesium do not prevent DCI or improve functional outcomes after aneurysmal subarachnoid hemorrhage (aSAH). Emerging data using multimodality monitoring has further advanced our understanding of the pathophysiology of DCI in poor grade aSAH. Summary The brief review will focus on the postinterventional care of aSAH patients outlining the recent advances over the past few years. aDepartment of Neurology and Anesthesiology, Wake Forest University School of Medicine, Winston Salem, North Carolina bDepartment of Neurology, Mayo Clinic, Rochester, Minnesota, USA Correspondence to Sudhir Datar, MD, Department of Neurology, Medical Center Blvd, Winston Salem, NC 27157, USA. E-mail: firstname.lastname@example.org Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.