Deans' stroke musings: International Position Paper on Outcome Selection After Aneurysmal Subarachnoid Hemorrhage

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, January 8, 2026

International Position Paper on Outcome Selection After Aneurysmal Subarachnoid Hemorrhage

You're missing the survivors' most important outcome: 100% RECOVERY! Not measuring for that is pure incompetence!

Here is your business101 requirements.

“What's measured, improves.” So said management legend and author Peter F. Drucker

The ONLY goal in stroke is 100% recovery! That is a survivor requirement, why the fuck aren't you getting there?

International Position Paper on Outcome Selection After Aneurysmal Subarachnoid Hemorrhage

Christopher R. Andersen, MD https://orcid.org/0000-0002-9321-8660,

Gordon Fernie, PhD,

Justin Presseau, PhD https://orcid.org/0000-0002-2132-0703,

Bev Shea, PhD https://orcid.org/0000-0002-7686-2585,

Maria Luisa Marti,

Isabel C. Hostettler, MD, PhD https://orcid.org/0000-0002-9004-2540,

Redi Rahmani, MD https://orcid.org/0000-0003-3161-2125,

Tracy A. Iona https://orcid.org/0009-0000-1033-2410, and

Shane W. English, MD https://orcid.org/0000-0002-9477-6146 senglish@toh.ca

on behalf of the SAH Core Domain Set and Core Domain Definitions Working Groups and the Canadian Critical Care Trials GroupAuthor Info & Affiliations

Stroke

New online

Abstract

The health outcomes currently reported in aneurysmal subarachnoid hemorrhage (aSAH) research lack consistency and do not sufficiently reflect what is important to people most affected. The objective of this article was to establish consensus on the aspects of health (domains) clinicians and researchers should measure in aSAH research.

METHODS:

Informed by 2 international prioritizing surveys (involving 239 participants from over 25 countries and 6 continents), we used established consensus methodology in a hybrid in-person/online consensus meeting to establish which domains of health researchers should measure in aSAH research. Sixty-nine participants with lived experience with aSAH (35%), clinical and research leaders (62%), or from aSAH-related charity (3%) took part. International multidisciplinary working groups established consensus definitions for each domain.

RESULTS:

Consensus (>70% endorsement) was sought on a proposed group of 6 domains of health, and failing that, each domain individually. The 6 domains which reached consensus and were formally defined are (1) health-related quality of life, (2) survival, (3) cognition and executive function, (4) functional outcome, (5) delayed cerebral ischemia and cerebral infarction, and (6) rebleeding and aneurysm obliteration.

CONCLUSIONS:

This International Position Statement reports the consensus process undertaken and the core domain set established to guide the choice of outcomes for evaluating new treatments for aSAH. It will ultimately help shape the future aSAH research agenda.