INTRODUCTION: Subarachnoid haemorrhage (SAH) may arise spontaneously or as a result of trauma. Spontaneous SAH accounts for about 5% of all strokes. Ruptured aneurysms are the cause of 85% of spontaneous SAH. The most characteristic clinical feature is sudden-onset severe headache. Other features include vomiting, photophobia, and focal neurological deficit or seizures, or both. As the headache may have insidious onset in some cases, or may even be absent, a high degree of suspicion is required to diagnose SAH with less typical presentations. METHODS AND OUTCOMES: We conducted a systematic review, aiming to answer the following clinical question: What are the effects of surgical treatments for people with confirmed aSAH? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). RESULTS: At this update, searching of electronic databases retrieved 82 studies. After deduplication and removal of conference abstracts, 47 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 33 studies and the further review of 14 full publications. Of the 14 full articles evaluated, one systematic review, one RCT, and four further reports were added at this update. We performed a GRADE evaluation for six PICO combinations. CONCLUSIONS: In this systematic overview, we categorised the efficacy for one comparison based on information about the effectiveness and safety of endovascular coiling versus surgical clipping.
INTRODUCTION:Subarachnoid haemorrhage (SAH) may arise spontaneously or as a result of trauma. Spontaneous SAH accounts for about 5% of all strokes. Ruptured aneurysms are the cause of 85% of spontaneous SAH. The most characteristic clinical feature is sudden-onset severe headache. Other features include vomiting, photophobia, and focal neurological deficit or seizures, or both. As the headache may have insidious onset in some cases, or may even be absent, a high degree of suspicion is required to diagnose SAH with less typical presentations. METHODS AND OUTCOMES: We conducted a systematic review, aiming to answer the following clinical question: What are the effects of surgical treatments for people with confirmed aSAH? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). RESULTS: At this update, searching of electronic databases retrieved 82 studies. After deduplication and removal of conference abstracts, 47 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 33 studies and the further review of 14 full publications. Of the 14 full articles evaluated, one systematic review, one RCT, and four further reports were added at this update. We performed a GRADE evaluation for six PICO combinations. CONCLUSIONS: In this systematic overview, we categorised the efficacy for one comparison based on information about the effectiveness and safety of endovascular coiling versus surgical clipping.
Authors: Andrew J Molyneux; Richard S C Kerr; Ly-Mee Yu; Mike Clarke; Mary Sneade; Julia A Yarnold; Peter Sandercock Journal: Lancet Date: 2005 Sep 3-9 Impact factor: 79.321
Authors: Adriana Campi; Najib Ramzi; Andrew J Molyneux; Paul E Summers; Richard S C Kerr; Mary Sneade; Julia A Yarnold; Joan Rischmiller; James V Byrne Journal: Stroke Date: 2007-03-29 Impact factor: 7.914
Authors: Cathal John Hannan; Abdurrahman I Islim; Andrew F Alalade; Andrew Bacon; Anthony Ghosh; Arthur Dalton; Ashraf Abouharb; Daniel Colman Walsh; Diederik Bulters; Edward White; Emmanouil Chavredakis; George Kounin; Giles Critchley; Graham Dow; Hiren C Patel; Howard Brydon; Ian A Anderson; Ioannis Fouyas; James Galea; Jerome St George; Jarnail Bal; Krunal Patel; Mahmoud Kamel; Mario Teo; Noel Fanning; Nitin Mukerji; Patrick Grover; Patrick Mitchell; Peter C Whitfield; Rikin Trivedi; Matthew T Crockett; Paul Brennan; Mohsen Javadpour Journal: Acta Neurochir (Wien) Date: 2022-10-11 Impact factor: 2.816