A plan for follow-up care and multidisciplinary rehabilitation after subarachnoid hemorrhage (SAH) should be developed and shared with the patient and their caregiver.
Follow-up neuroimaging should be considered for patients who have had an aneurysmal SAH.[66]American College of Radiology. ACR Appropriateness Criteria®: cerebrovascular diseases - aneurysm, vascular malformation, and subarachnoid hemorrhage. 2021 [internet publication].
https://acsearch.acr.org/docs/3149013/Narrative
http://www.ncbi.nlm.nih.gov/pubmed/34794589?tool=bestpractice.com
The choice of imaging modality and the frequency and duration of follow-up should be tailored to the individual patient and will usually be based on the type and outcome of any neurointervention or surgery on the initial aneurysm, the presence of any non-culprit aneurysm, estimated risk of further bleeding, risks of planned investigations and any subsequent interventions, and patient preference.[66]American College of Radiology. ACR Appropriateness Criteria®: cerebrovascular diseases - aneurysm, vascular malformation, and subarachnoid hemorrhage. 2021 [internet publication].
https://acsearch.acr.org/docs/3149013/Narrative
http://www.ncbi.nlm.nih.gov/pubmed/34794589?tool=bestpractice.com
Patients who have undergone coiling or clipping of a ruptured aneurysm should always have delayed follow-up vascular imaging to screen for the recurrence or regrowth of the treated aneurysm, or the development of new aneurysms.[37]Hoh BL, Ko NU, Amin-Hanjani S, et al. 2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2023 Jul;54(7):e314-70.
https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000436?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/37212182?tool=bestpractice.com
Retreatment may be considered if there is a clinically significant (e.g., growing) remnant.[37]Hoh BL, Ko NU, Amin-Hanjani S, et al. 2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association/American Stroke Association. Stroke. 2023 Jul;54(7):e314-70.
https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000436?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/37212182?tool=bestpractice.com
In patients with untreated, unruptured intracranial aneurysms, follow-up with a neurosurgeon/endovascular specialist is warranted to gauge the possible growth of aneurysm(s).