When hydrocephalus occurs acutely, the guidelines now advise diverting cerebrospinal fluid (CSF) by external ventricular drainage or lumbar drainage. Weaning from external drainage over a period longer than 24 hours does not appear to reduce the need for ventricular shunt placement. Permanent CSF diversion should be reserved for chronic, symptomatic hydrocephalus.
Recommendations on the management of seizures associated with aSAH and anesthesia during surgical and endovascular treatment remain unchanged from the previous guidelines.
The committee added a new section of recommendations on how to manage medical complications associated with aSAH, including hyponatremia and fluid imbalance, fever, elevated blood glucose levels, anemia, heparin-induced thrombocytopenia, and deep vein thrombosis. "For all of these, the areas may not be conclusive, but these are important topics that people often seek guidance for," Dr. Rabinstein said.
Dr. Rabinstein had no relevant disclosures. Some of the other members of the writing committee reported serving as consultants to or on the advisory boards of device manufacturers.