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Treating brain hemorrhage at higher volume stroke centers improves outcomes

Published: 11:08 am CDT, July 18, 2014

Treating a severe stroke known as subarachnoid hemorrhage at high-volume stroke centers results in fewer deaths, according to a study recently published in Neurology Today that is based on research presented at this year’s International Stroke Conference.

Subarachnoid hemorrhage, or SAH, occurs when a blood vessel bursts and bleeds into the lining between the surface of the brain and the brain tissue. More than 5 percent of all strokes are this type. Most SAHs are caused by a ruptured aneurysm or other trauma to the head.

According to the study, hospitals that treated more of these patients have better outcomes than low-volume hospitals with less experience.

In an analysis of almost 32,000 SAH patients in 685 hospitals from April 2003 to March 2012, high-volume stroke centers – primarily Comprehensive Stroke Centers or Primary Stroke Centers — had a 7.3 percent absolute reduction in early mortality after SAH.

“These results support efforts to regionalize stroke care so patients diagnosed with SAH after a CT scan are transported to high-volume centers where they have the best chance of a good outcome,” said one of the main authors of the study, Dr. Shyam Prabhakaran, MD, MS.

Potential reasons these high-volume hospitals show better results are that they offer both neurosurgical/neuroradiological expertise and have more resources and quality improvement systems than lower-volume centers. Other reasons included access to specialized services, level of staffing and organized multi-disciplinary stroke teams, researchers said.

Symptoms of SAH include a sudden, very severe headache that often starts at the back of the head and causes impaired or loss of consciousness. A congenital defect or a severe head injury can cause SAH. If these symptoms occur, call 9-1-1 immediately.