Prognosis of Aneurysmal Subarachnoid Haemorrhage: Facts and Figures

Subarachnoid haemorrhage is a haemorrhagic stroke, commonly caused by the rupture of a cerebral aneurysm. Although the mortality rate shows a decreasing trend, the aneurysmal subarachnoid haemorrhage (aSAH) is a catastrophic medical disease with higher morbidity and mortality. A quarter (25%) of aSAH patients die within 24 h of bleeding, even with medical management. The aSAH is a significant cause of increased morbidity and financial burden to the society as it requires more extended hospitalization, prolonged patient care, and loss of productivity. The aSAH causes both primary neurological damage, cognitive and psychological disorders, and secondary medical complications leading to distal non-neuro organ dysfunction. The neurological complications of aSAH contributing to the patient’s neurological morbidity and mortality are severity and expansion of the primary haemorrhage, re-bleed, cerebral vasospasm, delayed cerebral ischaemia, seizures, and the development of hydrocephalus. While medical complications are fever, hyperglycaemia, anaemia, pulmonary dysfunction, cardiac abnormalities, acute kidney injury, gastrointestinal haemorrhage, and haemopoietic dysfunctions. In patients with aSAH, the combination of physical neurological, cognitive, and psychological damage along with above mentioned medical complications and organ dysfunction lead to higher morbidity and mortality.