Clinical Updates and Perspectives on Subarachnoid Hemorrhage: 2nd Edition

Dear Colleagues,

It is our pleasure to invite you to contribute to a Special Issue titled “Clinical Updates and Perspectives on Subarachnoid Hemorrhage: 2nd Edition”. This is the second edition of the previous Issue; for more details on the first edition, please visit https://www.mdpi.com/journal/jcm/special_issues/BXB7SI9AA3.

Subarachnoid hemorrhage (SAH) is a severe condition with a mortality rate of approximately 35%. However, unlike ischemic stroke, the treatment outcomes for SAH have not significantly improved. The management of post-SAH brain injury and delayed cerebral ischemia (DCI) remains inadequate. The prognosis of SAH is influenced not only by the neurological severity at onset and surgical outcomes but also by the occurrence of delayed cerebral ischemia. Therefore, improving the treatment of DCI is crucial for enhancing the prognosis of SAH.

The etiology of DCI following SAH involves not only cerebral vasospasm but also primary brain injury, increased intracranial pressure, microcirculatory disturbances, microthrombosis, blood–brain barrier disruption, and cortical spreading ischemia. Therefore, a comprehensive prevention and treatment strategy is essential.

As a treatment for DCI, calcium channel blockers have been used in Western countries; however, supporting evidence remains insufficient. Recently, the efficacy of clazosentan has been reported in Japan, but unfortunately, randomized controlled trials (RCTs) conducted in Western countries failed to confirm its effectiveness. While there is no doubt that clazosentan is effective in preventing cerebral vasospasm, complications such as pulmonary edema have been reported, and no improvement in functional outcomes has been demonstrated. Nevertheless, issues such as postoperative management strategies warrant further investigation.

This Special Issue aims to highlight not only conventional pharmacological therapies but also the latest findings regarding the use and efficacy of emerging therapeutic agents.

Dr. Fusao Ikawa
Guest Editor

Manuscript Submission Information

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