Evidence map›Paper›PMID 40739674›Full record

ArticleNeurological research and practice2025

Acute care of aneurysmal subarachnoid hemorrhage: practical consensus statement from a multidisciplinary group of German-speaking neurointensivists and neuroradiologists on behalf of the DIVI neurology section.

Rainer Kollmar, Hagen B Huttner, Yigit Ozpeynirci, Christian Herweh, Jochen A Sembill, Stefan Gerner, Michael Bender, Patrick Schramm, Ingo Schirotzek, Lisa Maeder and 12 more

Abstract read
In one paragraph

Article in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Rainer KollmarKlinik für Neurologie und Neurointensivmedizin, Darmstadt, Germany. rainer.kollmar@mail.klinikum-darmstadt.de.ORCID http://orcid.org/0000-0002-3951-5269
Hagen B HuttnerUniversitätsklinikum Carl Gustav Carus Dresden, Klinik für Neurologie, Dresden, Germany.
Yigit OzpeynirciDepartment Neuroradiologie, Universitätsklinik Giessen, Giessen, Germany.
Christian HerwehDepartment für Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Jochen A SembillNeurologische Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Klinikum Darmstadt, Grafenstrasse 9, 64283, Darmstadt, Germany.
Stefan GernerNeurologische Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Klinikum Darmstadt, Grafenstrasse 9, 64283, Darmstadt, Germany.
Michael BenderKlinik für Neurochirurgie am Universitätsklinikum Giessen und Marburg GmbH, Giessen, Germany.
Patrick SchrammKlinik für Neurologie am Universitätsklinikum Giessen und Marburg GmbH, Giessen, Germany.
Ingo SchirotzekKlinik für Neurologie und Neurointensivmedizin, Darmstadt, Germany.
Lisa MaederKlinik für Neurologie und Neurointensivmedizin, Darmstadt, Germany.
Anisa MyftiuKlinik für Neurologie und Neurointensivmedizin, Darmstadt, Germany.
Marius HartmannInstitut für Radiologie, Neuroradiologie und Nuklearmedizin, Klinikum Darmstadt, Darmstadt, Germany.
Juergen KonczallaKlinik für Neurochirurgie, Goethe-Universität Frankfurt am Main, Frankfurt, Germany.
Karsten GeletnekyInstitut für Neurochirurgie, Klinikum Darmstadt, Darmstadt, Germany.
Rainer KramKlinik für Anaesthesiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
Raimund HelbokUniversitätsklinik für Neurologie, Johannes Kepler Universität Linz, Linz, Austria.
Joji B KuramatsuNeurologische Universitätsklinik Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Klinikum Darmstadt, Grafenstrasse 9, 64283, Darmstadt, Germany.
Martin WelteKlinikum Darmstadt, Klinik für Anästhesie und operative Intensivmedizin, Darmstadt, Germany.
Amr AbdulazimKlinik für Neurochirurgie, Universitätsklinikum Mannheim, Mannheim, Germany.
Emanuela KellerInstitut für Intensivmedizin, Universitätsklinikum Zürich, Zürich, Switzerland.
Ferdinand BohmannKlinik für Neurologie, Goethe-Universität Frankfurt am Main, Frankfurt, Germany.
Wolf-Rüdiger SchäbitzUniversitätsklinik für NeurologieEvangelisches Klinikum BethelUniversitätsklinikum OWL, Universität Bielefeld, Bielefeld, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAneurysmal subarachnoid hemorrhage (aSAH) is a critical condition requiring multidisciplinary management, particularly in the intensive care setting. Despite existing guidelines, gaps in evidence and variability in practice remain, necessitating practical, consensus-driven recommendations for acute care and management.

objectiveTo develop comprehensive, practical consensus statement for the acute management of aSAH, addressing high- and low-evidence areas, through a modified Delphi consensus approach among German-speaking neurointensivists and neuroradiologists.

methodsSenior experts from neurology, neurosurgery, neurocritical care, and interventional neuroradiology were selected for their academic and clinical expertise. The consensus process included iterative rounds of Delphi surveys, a face-to-face meeting, and online discussions. Consensus statements were formulated based on literature review, expert input, and iterative validation, with a consensus threshold of ≥ 70% agreement.

resultsThe group reached consensus on key aspects of aSAH management, including diagnostic protocols, invasive monitoring, blood pressure and temperature control, prophylactic and therapeutic measures for vasospasm and delayed cerebral ischemia, nutrition, and mobilization. Specific guidance was provided for early surgical/endovascular intervention, invasive hemodynamic monitoring, enteral nutrition initiation, and fever prevention. The consensus emphasized evidence-informed strategies where available and expert-derived recommendations in areas lacking robust data, such as therapeutic hypothermia and multimodal monitoring.

conclusionThis practical consensus statement provides a standardized approach to aSAH management, balancing guideline-based evidence with expert consensus to address clinical uncertainties. Due to the used methods and composition of the group, the results should be considered as a multi-institutional protocol of an experienced neurointensivist group, but certainly not as evidence based-guidelines. Adoption of this consensus may improve outcomes and harmonize care in the intensive management of aSAH.

Identifiers

PMID40739674
PMCPMC12312491

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.