Guidance
Recommendations for research
Recommendations for research
The guideline committee has made the following recommendations for research.
Key recommendations for research
1 Timing of CT head scans
What is the relative accuracy of CT head scans at different time intervals, for example 12 hours or 24 hours after symptom onset, to diagnose subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on diagnosing a subarachnoid haemorrhage.
Full details of the evidence and the committee's discussion are in evidence review B: diagnostic accuracy of investigations.
2 Predictors of death and disability
What variables predict death or disability for people with aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on diagnosing a subarachnoid haemorrhage.
Full details of the evidence and the committee's discussion are in evidence review C: severity scoring systems.
3 Nimodipine
What is the clinical and cost effectiveness of nimodipine in the management of aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on nimodipine.
Full details of the evidence and the committee's discussion are in evidence review D: medical management strategies.
4 Novel endovascular interventions
What is the clinical and cost effectiveness of novel endovascular techniques and devices such as coated coils, endoluminal flow diverters and intrasaccular devices to treat aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on managing the culprit aneurysm.
Full details of the evidence and the committee's discussion are in evidence review L: interventions to prevent re-bleeding.
5 Risk stratification tool to estimate risk of recurrence
What is the utility of a risk stratification tool to estimate the risk of subsequent aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on information and support.
Full details of the evidence and the committee's discussion are in evidence review N: risk of subsequent subarachnoid haemorrhage.
Other recommendations for research
Interventions for aneurysmal subarachnoid haemorrhage in people with major neurological deficit
What is the outcome of intervention to prevent rebleeding in people who present with or rapidly develop severe neurological deficits as a consequence of acute aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on managing the culprit aneurysm.
Full details of the evidence and the committee's discussion are in evidence review L: interventions to prevent re-bleeding.
Managing acute hydrocephalus
What is the most clinically and cost-effective method of cerebrospinal fluid drainage or diversion (for example shunt surgery, external ventricular drain surgery or lumbar drain) for symptomatic acute hydrocephalus?
For a short explanation of why the committee made this recommendation for research, see the rationale section on hydrocephalus.
Full details of the evidence and the committee's discussion are in evidence review H: managing hydrocephalus.
Transcranial doppler monitoring
What is the clinical and cost effectiveness of routine transcranial doppler monitoring to guide clinical management of aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on monitoring and investigating for deterioration.
Full details of the evidence and the committee's discussion are in evidence review E: monitoring for raised intracranial pressure and vasospasm.
Intracranial hypertension
What is the impact of routine monitoring of intracranial hypertension on subsequent management and outcome in people with aneurysmal subarachnoid haemorrhage who are unconscious or ventilated on an intensive care unit?
For a short explanation of why the committee made this recommendation for research, see the rationale section on intracranial hypertension.
Full details of the evidence and the committee's discussion are in evidence review I: detecting intracranial hypertension and evidence review J: managing intracranial hypertension.
Intra-arterial therapies to manage delayed cerebral ischaemia
What is the impact of intra-arterial therapies to manage delayed cerebral ischaemia on outcome in people with aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on delayed cerebral ischaemia.
Full details of the evidence and the committee's discussion are in evidence review F: management of delayed cerebral ischaemia.
Vasopressors to manage delayed cerebral ischaemia
What is the clinical and cost effectiveness of vasopressors to manage delayed cerebral ischaemia in people with aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on delayed cerebral ischaemia.
Full details of the evidence and the committee's discussion are in evidence review F: management of delayed cerebral ischaemia.
Blood pressure targets
What is the clinical and cost effectiveness of a lower blood pressure treatment target relative to the standard blood pressure treatment target for people with aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on managing other conditions after discharge from hospital.
Full details of the evidence and the committee's discussion are in evidence review Q: long-term medicines for reducing the risk of subsequent subarachnoid haemorrhage.
Investigations for relatives
What is the clinical and cost effectiveness of investigations to detect intracranial arterial aneurysms in first-degree relatives of people who have had an aneurysmal subarachnoid haemorrhage?
For a short explanation of why the committee made this recommendation for research, see the rationale section on investigations to detect aneurysms in relatives.
Full details of the evidence and the committee's discussion are in evidence review T: investigating relatives of people with aneurysmal subarachnoid haemorrhage.