Methadone Maintenance Therapy after Aneurysmal Subarachnoid Hemorrhage: A Case Report
Bibliographic record
Abstract
There is limited information on the effects of continued methadone maintenance therapy following aneurysmal subarachnoid hemorrhage (aSAH). However, with the increasing incidence of opioid use disorder (OUD) in the US, there is a need to define best practices for the management of pain and prevention of acute withdrawal syndrome in patients with pre-existing OUD who develop aSAH. In this case report, we describe the use of MMT in a patient with aSAH and discuss important considerations, including sedation or confusion that might mimic acute neurologic changes seen in cerebral vasospasm or delayed cerebral ischemia, cardiac complications related to QTc prolongation, and liver or kidney interactions associated with aSAH routine treatment. Our patient recovered from her aSAH without any adverse events and, with increased monitoring and collaborative team-based care, including input from those with expertise in OMD or aSAH, we believe MMT can be safely continued in most aSAH patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".