Triple-H therapy in the management of aneurysmal subarachnoid haemorrhage

Jon Sen, Antonio Belli, Helen Albon, Laleh Morgan, Axel Petzold, Neil Kitchen

Research output: Contribution to journalReview articlepeer-review


Cerebral vasospasm is a recognised but poorly understood complication for many patients who have aneurysmal subarachnoid haemorrhage and can lead to delayed ischaemic neurological deficit (stroke). Morbidity and mortality rates for vasospasm are high despite improvements in management. Since the middle of the 1970s, much has been written about the treatment of cerebral vasospasm. Hypervolaemia, hypertension, and haemodilution (triple-H) therapy in an intensive-care setting has been shown in some studies to improve outcome and is an accepted means of treatment, although a randomised controlled trial has never been undertaken. In this review, the rationale for this approach will be discussed, alongside new thoughts and future prospects for the management of this complex disorder.

Original languageEnglish
Pages (from-to)614-621
Number of pages8
JournalThe Lancet Neurology
Issue number10
Early online date15 Sept 2003
Publication statusPublished - Oct 2003


  • Calcium Channel Blockers/therapeutic use
  • Cerebrovascular Circulation/physiology
  • Disease Management
  • Hemodilution
  • Humans
  • Hypertension/etiology
  • Hypovolemia/etiology
  • Subarachnoid Hemorrhage/complications
  • Vasospasm, Intracranial/etiology


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