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INNOSC Theranostics and
Pharmacological Sciences Novel pharmacologic therapies for SAH

for individual patients may contribute to a reduction in vascular pathologies and isolated spinal artery aneurysms are
the occurrence of complications and facilitate targeted also identified as potential causes . Risk factors associated
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treatments. This approach provides future researchers the with SAH include hypertension and smoking . Symptoms
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opportunity to explore these novel therapies, aiming to commonly associated with SAH include severe headache,
manage diverse patient types with unique combinations neck pain, nausea or vomiting, and photophobia . In some
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tailored to the specific needs of each individual. Subsequently, cases, SAH may present with atypical symptoms such as
this research can contribute to the development of an back pain and lower-extremity weakness. Complications of
updated guideline for reference in the future. SAH that may result in death include hemorrhage, cerebral
The major limitation of this review lies in its inability edema, infection, pneumonia, external ventricular shunt, and
to evaluate the combinations of novel therapies along with ischemic damage 16-18 . A comprehensive understanding of the
the currently available traditional therapies. The principal causes and risk factors of SAH is important for its prevention,
objective of this article is to furnish comprehensive diagnosis, and effective treatment.
information regarding the current treatment options for 1.3. Symptoms and diagnosis of SAH
SAH, placing particular emphasis on the discovery and
ongoing research of novel therapies. Another objective is to Symptoms of SAH vary depending on the severity and
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provide researchers with a further direction for evaluating location of the bleeding . Common symptoms include
the efficacy of these therapies, especially when used in sudden and severe headaches, neck pain or stiffness,
combination with traditional therapy options. nausea and vomiting, sensitivity to light (photophobia),
changes in vision or double vision, seizures, and loss
This review was formulated based on the results of of consciousness 20-22 . The diagnosis of SAH typically
searches conducted on PubMed, Embase, Scopus, and involves a combination of medical history, physical
conference abstracts up to the year 2023 for studies examination, and imaging studies such as computed
related to SAH and its treatment. The study adheres to the tomography angiography or magnetic resonance imaging
PRISMA guidelines for systematic review. Information angiography 23,24 . The pathophysiological mechanisms and
was systematically retrieved from the aforementioned symptoms of SAH are illustrated in Figure 1.
databases, and relevant studies were identified based
on the crucial information they provided. Each article’s 2. Pathophysiology of SAH
information was thoroughly reviewed and extracted to
construct a comprehensive database. This approach ensured SAH is a complex and life-threatening condition
that the authors had access to all pertinent information characterized by blood infiltration into the subarachnoid
during the writing process of this review article, thereby space surrounding the brain. The pathophysiology of SAH
minimizing the risk of overlooking important details. involves a series of events that lead to both immediate and
delayed complications. The following subsections provide
1.1. Understanding SAH a comprehensive overview that integrates findings from
multiple references.
Blood can infiltrate the cerebrospinal fluid due to cerebral
insult, a burst intracranial aneurysm, and/or other severe 2.1. Rupture of intracranial aneurysm
head trauma, frequently resulting in a deadly condition
known as SAH . Failure to restore normal blood The rupture of an intracranial aneurysm plays a pivotal
1,2
flow can result in fatal consequences, including death, role in the pathophysiology of SAH. When considering
hydrocephalus, stroke, and permanent disability. SAH, a the pathogenesis of SAH, consulting these key sources
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form of cerebrovascular disease, is recognized as one of yields valuable insights. Osgood discusses the complex
the most severe and fatal neurological emergencies . It is pathophysiology of aneurysmal SAH, highlighting the
3
estimated that up to 50% of patients experiencing SAH significance of aneurysmal rupture as the primary trigger
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succumb within 30 days of onset, with an additional 30% for this devastating condition. Boling and Groves delve
suffering from moderate-to-severe morbidity . into the management of SAH, emphasizing that the rupture
4-8
of intracranial aneurysms leads to the sudden release of
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1.2. Causes and risk factors of SAH blood into the subarachnoid space. D’Souza provides a
Ruptures of pre-existing intracranial aneurysms are the comprehensive perspective on aneurysmal SAH, underlining
primary cause of SAH, affecting 1% to 5% of the general how the rupture of an intracranial aneurysm disrupts the
population . In addition, other causes, such as cerebrovascular normal cerebral environment and initiates a cascade of events.
3,9
malformations, vascular abnormalities at the skull base, and Furthermore, Sorrentino et al. contribute a
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head trauma, can also precipitate SAH 10-12 . Notably, spinal contemporary narrative review that specifically addresses

Volume 7 Issue 2 (2024) 2 doi: 10.36922/itps.2019