Management of subarachnoid hemorrhage

Subarachnoid hemorrhage (SAH), mostly from aneurysms, accounts for only 3% of all strokes [1] but for 5% of stroke deaths and for more than one quarter of potential lifeyears lost through stroke [2]. The twentieth century saw great advances in diagnosis, starting with the ability to recognize the condition at all during life. Advances in treatment and prevention of complications have also occurred, but until recently these have led to only modest improvement in overall outcome [3]. The gradual substitution of surgical clipping of ruptured aneurysms by endovascular occlusion that has started to evolve in the last decade is a great step forward [4, 5]. Nevertheless, there are still formidable challenges ahead for neurologists, neurosurgeons, and radiologists.