Subarachnoid hemorrhage primary prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Subarachnoid hemorrhage}} | {{Subarachnoid hemorrhage}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{SaraM}} | ||
==Overview== | |||
==Primary Prevention== | ==Primary Prevention== | ||
*Prevent head [[trauma]] | *Prevent head [[trauma]] | ||
*Identify and treat cerebral [[arteriovenous malformation]] or cerebral [[aneurysm]] | *Identify and treat cerebral [[arteriovenous malformation]] or cerebral [[aneurysm]] | ||
{|class="wikitable" | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Treatment of high blood pressure with [[antihypertensive medication]] is recommended to prevent [[ischemic stroke,]] i[[ntracerebral hemorrhage]], and cardiac, renal, and other [[end-organ injury]] ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[Hypertension]] should be treated, and such treatment may reduce the risk of aSAH ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Tobacco use and alcohol misuse should be avoided to reduce the risk of aSAH ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''4.''' After any aneurysm repair, immediate cerebrovascular imaging is generally recommended to identify remnants or recurrence of the aneurysm that may require treatment ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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{|class="wikitable" | |||
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' In addition to the size and location of the aneurysm and the patient’s age and health status, it might be reasonable to consider morphological and hemody- namic characteristics of the aneurysm when discuss- ing the risk of aneurysm rupture ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
|- | |||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Consumption of a diet rich in vegetables may lower the risk of aSAH ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' It may be reasonable to offer noninvasive screening to patients with familial (at least 1 first-degree relative) aSAH and/or a history of aSAH to evaluate for de novo aneurysms or late regrowth of a treated aneurysm, but the risks and benefits of this screening require further study ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 14:32, 13 December 2016
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Subarachnoid Hemorrhage Microchapters |
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Diagnosis |
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Treatment |
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AHA/ASA Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage (2012)
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Case Studies |
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Subarachnoid hemorrhage primary prevention On the Web |
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American Roentgen Ray Society Images of Subarachnoid hemorrhage primary prevention |
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Risk calculators and risk factors for Subarachnoid hemorrhage primary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Primary Prevention
- Prevent head trauma
- Identify and treat cerebral arteriovenous malformation or cerebral aneurysm
| Class I |
| "1. Treatment of high blood pressure with antihypertensive medication is recommended to prevent ischemic stroke, intracerebral hemorrhage, and cardiac, renal, and other end-organ injury (Level of Evidence: A)" |
| "2. Hypertension should be treated, and such treatment may reduce the risk of aSAH (Level of Evidence: B)" |
| "3. Tobacco use and alcohol misuse should be avoided to reduce the risk of aSAH (Level of Evidence: B)" |
| "4. After any aneurysm repair, immediate cerebrovascular imaging is generally recommended to identify remnants or recurrence of the aneurysm that may require treatment (Level of Evidence: B)" |
| Class IIb |
| "1. In addition to the size and location of the aneurysm and the patient’s age and health status, it might be reasonable to consider morphological and hemody- namic characteristics of the aneurysm when discuss- ing the risk of aneurysm rupture (Level of Evidence: B)" |
| "2. Consumption of a diet rich in vegetables may lower the risk of aSAH (Level of Evidence: B)" |
| "3. It may be reasonable to offer noninvasive screening to patients with familial (at least 1 first-degree relative) aSAH and/or a history of aSAH to evaluate for de novo aneurysms or late regrowth of a treated aneurysm, but the risks and benefits of this screening require further study (Level of Evidence: B)" |