About this Research Topic
Aneurysmal subarachnoid hemorrhage (SAH) accounts for 5% of all strokes and affects up to 22 per 100,000 persons per year worldwide. The 30-day morbidity and mortality have been reported to be as high as 50 and 40%, respectively. Emergent treatment of aneurysmal subarachnoid hemorrhage is primarily focused on securing the ruptured aneurysm by surgical or endovascular means. At one point, microsurgical aneurysmal clipping was the standard of care. With the advent of endovascular therapy reaching parity by 2005 in the USA, craniotomy and microsurgical clipping has declined. Management of aneurysmal subarachnoid hemorrhage has advanced significantly since endovascular therapy for intracranial aneurysms started more than 20 years ago.
Symptomatic vasospasm occurres aproximately in 39% of patients treated with clip application, 30% of patients treated with endovascular coil occlusion, and 37% of patients overall. Nevertheless, there is no significant difference in overall outcome at the longest follow-up examination between the two treatment groups.
It seems that the amount of blood in basal cisterns on computed tomography, vascular manipulation, and brain retraction had the same triggering effect on vasospasm-induced ischemia.
In contrast to endovascular treatment, aneurysm surgery seems to be associated with an increased incidence of mood disorders corresponding to hippocampal neuronal loss, independent of preceding SAH.
The main goal of this Research Topic is to determine if the endovascular coiling offers superrior clinical outcome in comparison to the neurosurgical clipping. The focus is on postoperative complications, surgical and intensive care, and long term outcome in regard to neurological and psychiatric sequelae.
Another point of interest is in regard with the neuronal damage and detectable metabolites as prognostic factors.
Some differences in postoperative care are in neuromonitoring and the possible role of specific therapy and monitoring i.e. normobaric hiperoxia, cerebral oxymetry, microdyalisis, jugular vein bulb oximetry.
Thus, topic editors will welcome any types of manuscripts supported by the Journal – comprised of research article, brief research article, review, and mini-review – pertaining, but not limited to the following themes:
• differences in clinical outcome between clipping and coiling
• complications
• neurological sequelae
• specific monitoring
• delayed ischemia
• metabolites and biomarkers as prognostic factors for neuronal damage i.e hippocampal damage and mood disorders and memory impairment
Symptomatic vasospasm occurres aproximately in 39% of patients treated with clip application, 30% of patients treated with endovascular coil occlusion, and 37% of patients overall. Nevertheless, there is no significant difference in overall outcome at the longest follow-up examination between the two treatment groups.
It seems that the amount of blood in basal cisterns on computed tomography, vascular manipulation, and brain retraction had the same triggering effect on vasospasm-induced ischemia.
In contrast to endovascular treatment, aneurysm surgery seems to be associated with an increased incidence of mood disorders corresponding to hippocampal neuronal loss, independent of preceding SAH.
The main goal of this Research Topic is to determine if the endovascular coiling offers superrior clinical outcome in comparison to the neurosurgical clipping. The focus is on postoperative complications, surgical and intensive care, and long term outcome in regard to neurological and psychiatric sequelae.
Another point of interest is in regard with the neuronal damage and detectable metabolites as prognostic factors.
Some differences in postoperative care are in neuromonitoring and the possible role of specific therapy and monitoring i.e. normobaric hiperoxia, cerebral oxymetry, microdyalisis, jugular vein bulb oximetry.
Thus, topic editors will welcome any types of manuscripts supported by the Journal – comprised of research article, brief research article, review, and mini-review – pertaining, but not limited to the following themes:
• differences in clinical outcome between clipping and coiling
• complications
• neurological sequelae
• specific monitoring
• delayed ischemia
• metabolites and biomarkers as prognostic factors for neuronal damage i.e hippocampal damage and mood disorders and memory impairment
Keywords: SAH, Surgical clipping, endovascular coiling, vasospasm, neuronal loss
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
