KUH, one of the five university hospitals in Finland, is an academic, non-profit, publicly funded tertiary center, serving a defined catchment population in Eastern Finland (Fig. 1 ). The KUH area contains four central hospitals with catchment areas of their own (Fig. 1 ), providing full-time neurology, intensive care, and CT services.![]()
Neurointensive care is provided regardless of the condition on admission, including Hunt and Hess comatose grade V patients. A dedicated team of neurointensivists, neurosurgeons, and neuroradiologists coordinates the aSAH treatment. KUH Neurovascular group provides microsurgical or endovascular occlusion of the ruptured aneurysm; cases with significant ICH are immediately treated microsurgically. The protocol follows international recommendations in detail [5 (link), 14 (link), 21 (link)], aiming to prevent further brain damage due to re-bleeding, increased intracranial pressure (ICP), hydrocephalus, electrolyte disturbances, seizures, cardiac and pulmonary dysfunction, fever, hyperglycemia, and development of delayed brain ischemia. The protocol includes, when appropriate, e.g., external ventricular drainage (EVD), parenchymal ICP monitoring, endovascular procedures, and intra-arterial nimodipine infusion in case of delayed brain ischemia, as well as decompressive craniectomy (DC).
Map of the catchment area of the Kuopio University Hospital (KUH), containing 4 central hospitals (Joensuu, Jyväskylä, Mikkeli, Savonlinna) with acute neurology and CT services. All patients with acute aSAH are referred to KUH Neurosurgery and KUH Neurointensive Care
Neurointensive care is provided regardless of the condition on admission, including Hunt and Hess comatose grade V patients. A dedicated team of neurointensivists, neurosurgeons, and neuroradiologists coordinates the aSAH treatment. KUH Neurovascular group provides microsurgical or endovascular occlusion of the ruptured aneurysm; cases with significant ICH are immediately treated microsurgically. The protocol follows international recommendations in detail [5 (link), 14 (link), 21 (link)], aiming to prevent further brain damage due to re-bleeding, increased intracranial pressure (ICP), hydrocephalus, electrolyte disturbances, seizures, cardiac and pulmonary dysfunction, fever, hyperglycemia, and development of delayed brain ischemia. The protocol includes, when appropriate, e.g., external ventricular drainage (EVD), parenchymal ICP monitoring, endovascular procedures, and intra-arterial nimodipine infusion in case of delayed brain ischemia, as well as decompressive craniectomy (DC).
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