Patients who are diagnosed in the emergency room with a specifictype of brain bleed should be considered for immediate transfer toa hospital that treats at least 35 cases a year, according to a newscientific statement from the American Heart Association/AmericanStroke Association. The Guidelines for the Management of Aneurysmal SubarachnoidHemorrhage (aSAH) is published online in Stroke , an American Heart Association Journal. It updates guidelinesissued in 2009. "Admission to high-volume centers has been associated with lowerdisability and death," said E. Sander Connolly, Jr., M.D., chair ofstatement writing group. Research indicates 30-day death rates were significantly higher inlow-volume facilities: 39 percent in hospitals admitting less than10 patients compared to 27 percent in hospitals treating more than35 patients each year. "While the reasons for this association are not completely clear,patients admitted to high-volume facilities have increased accessto experienced cerebrovascular surgeons and endovascularspecialists, as well as multidisciplinary neuro-intensive careservices, such as EEG monitoring to rule out non-convulsive statusseizures," said Connolly, who is also the vice-chairman ofneurological surgery at Columbia University in New York and theco-director of the neurosciences intensive care unit at NewYork-Presbyterian Hospital. Aneurysmal subarachnoid hemorrhage occurs when a weakened bloodvessel ( aneurysm ) deep within the brain expands out like a balloon then ruptures,causing bleeding into the space around the brain. It is responsiblefor about 5 percent of all strokes and affects more than 30,000 Americans each year, most of thembetween ages 40 and 60 years old. Prevention recommendations still center on controlling hypertension , avoiding cigarette smoking and avoiding excessive alcoholconsumption. Aneurysms can be treated by a microsurgical procedure to seal thedamaged portion of the blood vessel with a clip, or a less invasiveprocedure from within the vessel by placing a number of detachablemetal coils within the aneurysm. Both techniques have been shown toprevent re-bleeding of the aneurysm in most cases. Some of the other 21 new recommendations include: Between onset of aSAH symptoms and treatment of the aneurysm, bloodpressure should be controlled with an agent to balance the risk ofstroke and hypertension-related re-bleeding, and to maintaincerebral perfusion pressure. Unless there is a compelling contraindication, follow-up imagingafter coiling or microsurgical clipping of an aneurysm should bedelayed, and strong consideration should be given to retreatment ifthe remnant is growing. Experienced cerebrovascular surgeons and endovascular specialistsshould determine a multidisciplinary treatment approach based oncharacteristics of the patient and the aneurysm. While the statement urges physicians "to use these guidelines asmerely the starting point for doing everything possible to improvethe outcomes of patients with aSAH," Connolly urges people to actquickly if symptoms appear. The classic symptom of aSAH is a severe headache that develops suddenly ("thunderclap headache"), and is oftenaccompanied by vomiting, confusion, loss of consciousness andsometimes seizures. "Most people do not recognize when aSAH is occurring, and anyonewho experiences the 'worst headache of your life,' should get tothe closest ER immediately," Connolly urged. Additional References Citations. We are high quality suppliers, our products such as China Ceramic Coated Glass , Curved Tempered Glass Manufacturer for oversee buyer. To know more, please visits Tempered Safety Glass.
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