Intensive Management of Pressure and Volume Expansion in Patients With Subarachnoid Hemorrhage

Efficacy of Triple-H therapy.

Inclusion criteria

• Age more than or equal to 18 years
• Aneurysmal SAH of any clinical grade
• Head computed tomography demonstrating SAH
• Cerebral angiography revealing the presence of cerebral aneurysm(s) in a location that explains the SAH
• Treatment of aneurysm with clipping or coiling must be carried out prior to randomization and within 72 hours of bleeding
• Signed consent by study participant or applicable legal representative within 72 hours after SAH

Exclusion criteria

• History of traumatic SAH
• Non-aneurysmal SAH as indicated by no demonstrable aneurysm by cerebral angiography
• Presence of an unsecured intracranial aneurysm(s) at risk of rupture that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data
• Delayed referral with clipping/coiling greater than 72 hours after the initial bleeding
• Time of symptom onset cannot be reliably determined
• Intracranial hypertension (ICP >25 mm Hg) at the time of screening
• History within the past six months and/or physical findings on admission of decompensated congestive heart failure (NYHA functional class III or IV, or objective class C or D)
• Acute, evolving or recent myocardial infarction
• Cardiac arrhythmia or second and third degree atrio-ventricular block causing hemodynamic instability
• Chronic renal failure requiring dialysis
• Suspected or confirmed pregnancy
• Non English speaking
• A condition that would preclude the performance of the neurobehavioral test battery due to a prior diagnosis of Alzheimer's disease, stroke, degenerative condition, cerebral tumor, or mental retardation
• Severe terminal disease with life expectancy less than 6 months
• Refusal of consent