Perioperative management of patients with intracranial aneurysms

Spontaneous aneurysmal subarachnoid hemorrhage is a complex illness with a high mortality and morbidity rate. Treatment requires a multidisciplinary a pproach and implies knowledge of the specific pathogenesis, neurophysiology , pharmacology, and of the medical sequelae related to aneurysmal bleeding. Treatment modalities are under constant evaluation whereby the aim remains the definite exclusion of the aneurysm from the cerebral circulation to av oid rebleeding and to enable the physician to treat cerebral ischemia with neurologic deficits aggressively. Anaesthesiologists are often involved in preclinical and especially perioperative care. Efforts should be directed t owards an improvement of neurologic and medical recovery of these mostly yo ung patients.