Jefferson Neurosurgeon Helps Revise Guidelines on Management of Aneurysmal Subarachnoid Hemorrhages
Robert Rosenwasser, MD, served as part of a special writing group -- made up of 10 of the leading neurosurgeons and vascular neurologists in the country. It was the first revision to the American Heart Association's Stroke Council guidelines since 1994.
Robert Rosenwasser, MD, Professor and Chair, Department of Neurological Surgery at Jefferson Medical College, served as part of a special writing group -- made up of 10 of the leading neurosurgeons and vascular neurologists in the country -- to establish these new guidelines for the management of aneurysmal subarachnoid hemorrhage (aSAH). The guidelines from the Stroke Council of the American Heart Association are now available in the online edition of Stroke.
More than 27,000 Americans suffer ruptured intracranial aneurysms each year. An estimated 10 to 15 percent of patients die before reaching the hospital. Mortality rates reach as high as 45 percent within the first 30 days and about half die in the first six months.
“Even though aSAHs can be lethal, there have been great advances in treatment since the first and only guidelines on their management were published in 1994 which necessitated the revision,” said Dr. Rosenwasser, who also was a co-author on the Guidelines for the Early Management of Adults with Ischemic Stroke issued by the American Heart Association/American Stroke Association in 2007. “Advancements in imaging, critical care and new clinical procedures utilizing coils and catheters, allow for better patient outcomes, so the way in which a ruptured aneurysm or ischemic stroke are diagnosed and treated needed to be adjusted to reflect current times.”
To address these changes, the Stroke Council formed a writing group to re-evaluate the initial recommendations from 14 years ago. The committee conducted a MEDLINE search, retaining all relevant literature published between June 1994 and November 2006, which met the criteria of a randomized trial or a nonrandomized, concurrent, cohort study, with the goal of addressing subjects that were covered in the initial guidelines.