Multicentric registry study in order to define outcome, predictors, treatment effects and their modifiers in poor grade aneurysmal subarachnoid haemorrhage patients. The search for outcome predictors is going to be subdivided into three main research areas: 1. outcome predictors in the emergency department (so called "early brain injury phase"). 2. outcome predictors in the neurocritical care unit (so called "delayed brain injury phase"). 3. Treatment strategies. Two other areas of research are identified: delayed cerebral ischemia (incidence, treatment, predictors, impact on outcome) and long term follow-up (recent evidences suggest that there may be a non-negligible proportion of poor grade subarachnoid hemorrhage patients who may benefit from substantial improvement at long-term (after 6-12 months of follow-up).
Study Type
OBSERVATIONAL
Enrollment
800
Standard management according to international/national guidelines. Observational study
ASST Ospedale Papa Giovanni XXIII
Bergamo, Italy
ACTIVE_NOT_RECRUITINGIRCCS Bellaria
Bologna, Italy
RECRUITINGAzienda Ospedaliera Spedali Civili
Brescia, Italy
RECRUITINGOspedale Vito Fazzi
Lecce, Italy
RECRUITINGIRCCS San Raffaele
Milan, Italy
RECRUITINGOspedale Maggiore della Città di Novara
Novara, Italy
RECRUITINGAzienda Ospedaliero-Universitaria di Parma
Parma, Italy
RECRUITINGPoliclinico Universitario Agostino Gemelli
Roma, Italy
ACTIVE_NOT_RECRUITINGOspedale Santissima Annunziata
Taranto, Italy
RECRUITINGAzienda Ospedaliera Universitaria Integrata
Verona, Italy
RECRUITINGClinical Outcome
modified Rankin Scale
Time frame: 6 months.
Clinical Outcome
modified Rankin Scale (mRS). Scale ranging from 0 (no symptoms) to 6 (dead) with higher scores indicating increasing neurological disability.
Time frame: 12 months
Long-Term clinical outcome
modified Rankin Scale (mRS). Scale ranging from 0 (no symptoms) to 6 (dead)
Time frame: 12-60 months
Delayed Cerebral Ischemia
Delayed Cerebral Ischemia
Time frame: onset-30 days
Rebleeding
Rebleeding
Time frame: onset-48hours
Treatment Complications
Treatment Complications
Time frame: onset-1 week
Decompressive Craniotomy
Incidence, strategy (primary or secondary), predictors and clinical impact
Time frame: onset-3 weeks
Ventriculo-peritoneal shunt
Incidence, strategy (primary or secondary), predictors and clinical impact
Time frame: onset-4 weeks
CSF drainage
Use of external ventricular drainage or lumbar drainage according to institutional protocol. Clinical impact.
Time frame: onset-3 weeks
Volumetric analysis of intracranial bleeding
Volumetric analysis and distribution assessment of intracranial bleeding. Clinical impact
Time frame: onset-24hours
Volumetric analysis of delayed cerebral ischemia
Volumetric analysis and location assessment of delayed cerebral ischemia. Clinical impact
Time frame: onset-3 weeks
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