University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Critical Care


Tom Colletti


A subarachnoid hemorrhage (SAH) is the accumulation of blood between the pia mater and the arachnoid mater and is considered a neurological emergency associated with significant morbidity and mortality. Causes of SAH can include arteriovenous malformation or fistula, arterial dissection, tumor, venous thrombosis, vasculitis, and most commonly, aneurysm rupture, accounting for more than 80% of cases.1 Aneurysmal SAH (aSAH) can be viewed as a disease process with three phases occurring on a continuum—the acute phase (first 24 hours after rupture), the subacute phase (24-72 hours), and the chronic phase (day 3 -14) hallmarked by delayed cerebral ischemia (DCI) and cerebral vasospasm. Management of the acute and subacute phases focuses on the prevention of rebleeding and management of secondary complications such as hydrocephalus, seizures, and cardiopulmonary dysfunction. The management of the chronic phase focuses on the prevention of DCI with a multimodal monitoring approach using serial clinical examinations, both noninvasive and invasive monitoring strategies, and initiation of oral nimodipine.


Available when accessing via a campus IP address or logged in with a University of Lynchburg email address.

Off-campus users can also use 'Off-campus Download' button above for access.