Javed Anees: The Essentials of aSAH Management
Javed Anees, Medical Consultant at Government of Kerala, shared a post on LinkedIn:
“Aneurysmal Subarachnoid Hemorrhage (aSAH) remains one of the most time-critical neurological emergencies, where every minute matters.
Early recognition of a thunderclap headache, prompt non-contrast CT, rapid CT angiography, timely aneurysm securing (coiling or clipping), and meticulous neurocritical care are the cornerstones of improving survival and functional outcomes.
Key evidence-based messages:
Secure the aneurysm early to prevent catastrophic rebleeding.
Nimodipine for 21 days remains the only pharmacological therapy consistently shown to improve neurological outcomes by reducing delayed cerebral ischemia.
Goal-directed euvolemia has replaced routine Triple-H therapy.
Continuous monitoring for vasospasm, hydrocephalus, electrolyte disturbances, cardiac dysfunction, and delayed cerebral ischemia is essential in the Neuro-ICU.
Successful management requires seamless collaboration between Emergency Medicine, Neurology, Neurosurgery, Neurointervention, Neurocritical Care, Radiology, and Rehabilitation.
I created this evidence-based educational infographic by integrating current recommendations from the 2023 AHA/ASA Guidelines, Neurocritical Care Society guidance, and landmark neurovascular studies to provide a practical, high-yield resource for clinicians and trainees.”

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