Early Blood Pressure Intervention After Coiling or Clipping for Subarachnoid Hemorrhage

Inclusion criteria

• 1) Aged 18-75 years;

• Patients who underwent clipping or endovascular intervention within 72 hours post-ictus;

• Intracranial aneurysm diagnosis confirmed by operating surgeons (including neurosurgeons or neurointerventionalists) through imaging findings, intraoperative visualization, or angiography, with subarachnoid hemorrhage (SAH) attributable to the ruptured aneurysm lesion (verified via imaging, xanthochromic cerebrospinal fluid, or intraoperative observation);

• Hunt-Hess grade 1-4 at onset;

Exclusion criteria

• 1) Presence of untreated intracranial aneurysms with rupture risk;

• Moderate-to-severe cerebral vasospasm confirmed by pre-enrollment digital subtraction angiography (DSA), transcranial Doppler (TCD), or computed tomography angiography (CTA);

• Intracranial massive hematoma (e.g., volume >30 mL with midline shift >5 mm) causing severe cerebral herniation, as evidenced by admission CT or other imaging modalities;

• Prior cranial neurosurgery for other central nervous system disorders;

• Comorbid major systemic diseases or multi-organ dysfunction with life expectancy <1 year, potentially compromising study implementation or follow-up observations;

• Poorly controlled hypertension despite regular antihypertensive medication (e.g., systolic blood pressure >160 mmHg during pharmacotherapy);

• Pre-onset modified Rankin Scale (mRS) score >2 points, indicating disability from other causes;

• Intraoperative major complications including but not limited to massive cerebral hemorrhage, hypovolemic shock, or malignant brain swelling;

• Anticipated inability to complete scheduled follow-up assessments within 180 days;

• Pregnancy.