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JCM
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Recent Advances and Future Perspectives of Subarachnoid Hemorrhage
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Recent Advances and Future Perspectives of Subarachnoid Hemorrhage

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1763

Special Issue Editors

Dr. Alexandros Doukas

E-Mail Website
Guest Editor
Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
Interests: subarachnoid hemorrhage; neurotrauma; neuromonitoring; neurointensive care
Prof. Dr. Athanasios K. Petridis

E-Mail Website
Guest Editor
1. Department of Neurosurgery, St. Luke Hospital, Thessaloniki, Greece
2. Medical School, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
Interests: cerebrovascular surgery; neurosurgery; intracranial bleeding; subarachnoid hemorrhage; microsurgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Subarachnoid hemorrhage is a potentially life-threatening type of brain hemorrhage of which around 22–26% of patients die before reaching a hospital and many suffer from permanent neurological deficits, in many cases requiring permanent care at home. It affects around 6.1/100,000 person-years, and the average age of patients affected is between 50 and 60 years old. Although the outcome of patients has improved over time, the overall 30-day mortality is around 35%. The most common cause is the rupture of intracranial aneurysms followed by the rupture of AVMs or arteriovenous fistulas.

In this Special Issue we aim to focus on neurocritical aspects and future treatment options of patients with subarachnoid hemorrhage in order to improve functional outcomes, adhering to the current guidelines. Our vision is to continue evolving by implementing new monitoring options and therapeutic strategies, from confirming the cause of a subarachnoid hemorrhage to managing its complications.

Topics will include the following:

  • Neuromonitoring.
  • Pharmacological or interventional treatments of complications such as delayed cerebral ischemia and delayed neurological deficits.

Dr. Alexandros Doukas
Prof. Dr. Athanasios K. Petridis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • subarachnoid hemorrhage
  • neuromonitoring
  • neurocritical care
  • neurointerventions
  • neurointensive care

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Published Papers (1 paper)

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Research

16 pages, 960 KB  
Article
Vasopressin Improves Cerebral Perfusion Pressure but Not Cerebral Blood Flow or Tissue Oxygenation in Patients with Subarachnoid Hemorrhage and Norepinephrine-Refractory Hypotension: A Preliminary Evaluation
by Sylvia Bele, Elisabeth Bruendl, Nils Ole Schmidt, Martin Proescholdt and Martin Kieninger
J. Clin. Med. 2025, 14(23), 8517; https://doi.org/10.3390/jcm14238517 - 1 Dec 2025
Viewed by 1347
Abstract
Background: Maintaining an adequate mean arterial pressure (MAP) and cerebral perfusion pressure to ensure proper perfusion and oxygen delivery to all major organs is crucial—especially for neurosurgical patients after subarachnoid hemorrhage or traumatic brain injury—for preventing secondary brain damage or delayed cerebral [...] Read more.
Background: Maintaining an adequate mean arterial pressure (MAP) and cerebral perfusion pressure to ensure proper perfusion and oxygen delivery to all major organs is crucial—especially for neurosurgical patients after subarachnoid hemorrhage or traumatic brain injury—for preventing secondary brain damage or delayed cerebral ischemia. Currently, most neurosurgical intensive care units rely on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) values to guide therapy. Fluid resuscitation and norepinephrine are standard treatments for achieving a CPP between 60 and 70 mmHg; however, patients sometimes experience norepinephrine-refractory hypotension. In such cases, vasopressin is often the preferred medication; it is widely utilized and has gained interest in treating septic shock or refractory hypotension following cardiac surgery or hypovolemic shock. Recent studies have also shown the significant impact of vasopressin on resuscitation after traumatic brain injury (TBI) and its effect on CPP during ICU care. Nevertheless, little is known about how vasopressin affects cerebral perfusion and oxygenation, especially in patients with subarachnoid hemorrhage. Methods: This preliminary retrospective single-arm study examined how vasopressin affects PbtO2 and cerebral blood flow using the non-invasive QuantixND® device. After administering vasopressin for treating catecholamine-refractory hypotension, MAP, CPP, ICP, PbtO2, and cerebral blood flow were measured over a 20-min period. Results: In this small cohort, vasopressin sufficiently improved MAP and CPP over a 20 min period following AVP bolus administration with a slight decline at later time points. The ICP decreased throughout this period, indicating some level of autoregulation. In contrast, cerebral blood flow did not improve despite the rise in CPP, and PbtO2 levels remained below 20 mmHg. Conclusions: We conclude that vasopressin could be a viable option for maintaining MAP and CPP, but caution should be exercised in patients with already impaired cerebral perfusion. Furthermore, relying solely on CPP as the therapeutic guide in subarachnoid hemorrhage patients appears to be at least questionable. Full article
(This article belongs to the Special Issue Recent Advances and Future Perspectives of Subarachnoid Hemorrhage)
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