Treatment of Aneurysmal Subarachnoid Hemorrhage with Intraoperative Elevated Intracranial Pressure and Cerebral Edema During Aneurysm Surgery

Clinical Scenario

This protocol addresses patients with aneurysmal subarachnoid hemorrhage (aSAH) who develop elevated intracranial pressure and cerebral edema during aneurysm surgery. This intraoperative complication requires prompt management to maintain adequate cerebral perfusion and minimise secondary injury.

Specific Situation

The scenario involves aSAH patients in whom elevated intracranial pressure and cerebral edema arise as intraoperative findings during the surgical procedure for aneurysm repair — a setting where real-time pressure management is critical to surgical access and neurological outcome.

Treatment Approach & Goals

The approach involves intraoperative administration of an osmotic agent to reduce elevated intracranial pressure and cerebral swelling. The complete protocol — including agent selection, conditions for use, and full clinical decision algorithm — is available via the link below.

Clinical goal: reduction of intracranial pressure and cerebral edema to facilitate safe surgical completion.