Aneurysmal subarachnoid hemorrhage

Aneurysmal subarachnoid hemorrhage (SAH) is among the most critical acute cerebrovascular conditions, marked by high mortality rates, significant disability, and a considerable socio-economic burden. Women over 55 years of age, as well as individuals with arterial hypertension, hereditary predispositions, congenital vascular anomalies, and a history of smoking, are particularly susceptible. This article consolidates current data on the epidemiology, risk factors, pathogenesis, clinical presentation, and diagnosis of aneurysmal SAH. Special emphasis is placed on the mechanisms of early brain injury and delayed cerebral ischemia—two crucial factors influencing disease outcomes. Contemporary therapeutic strategies, including microsurgical clipping and endovascular embolization, are discussed in depth, addressing their indications, effectiveness, and associated risks. The significance of prompt diagnosis, specialized approaches, and patient management in neurovascular centers is highlighted. A systematic, multistage, and interdisciplinary strategy for managing patients with acute aneurysmal SAH is examined, demonstrating an approach that can enhance survival and improve functional outcomes while minimizing the risk of rebleeding and severe neurological deficits.