Definitive management of aneurysmal subarachnoid hemorrhage involves which intervention?

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Securing the ruptured aneurysm to prevent rebleeding is the definitive treatment. This is achieved by either surgical clipping or endovascular coiling. Clipping places a small clip across the aneurysm neck to stop blood flow into the pouch, while coiling fills the aneurysm with detachable coils to promote clotting inside the aneurysm and exclude it from circulation. Both aim to prevent further bleeding while preserving the parent vessel, with the choice based on aneurysm anatomy and patient factors. After securing the aneurysm, management shifts to preventing complications like vasospasm and hydrocephalus; simply observing or using antibiotics or steroids does not definitively treat the source of hemorrhage.