Tuesday 21 Oct 2014

Information and opinions presented here do not always represent the views of the American Heart Association.

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.