The JVIN Podcast is the official audio channel of the Journal of Vascular and Interventional Neurology — one of the leading peer-reviewed publications dedicated to cerebrovascular disease and interventional neurology. Each episode brings together world-class clinicians, researchers, and innovators for in-depth conversations that go beyond the printed page.

Whether you are a practicing neurologist, neurointerventionalist, vascular neurosurgeon, or a trainee building your clinical foundation, the JVIN Podcast delivers the insights, evidence, and expert perspectives that matter most to your practice. From landmark trial breakdowns to emerging endovascular techniques, from stroke systems of care to the latest in neuroprotection — we cover the full spectrum of vascular and interventional neurology in a format you can take anywhere.

Hosted and curated by the journal's editorial leadership, every episode reflects the same rigorous scientific standards that define JVIN's published research — now in a conversation you can listen to on your commute, between cases, or wherever your day takes you.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) management across the diverse healthcare landscapes of the Middle East and North Africa (MENA) region requires evidence-based guidelines adapted to varying resource levels. The MENA Stroke and Interventional Neurotherapies Organization (MENA-SINO) developed these guidelines to address critical regional challenges while maintaining core principles of care.

Methods: We adapted evidence from multiple international guidelines (AHA/ASA, ESO, NICE, Neurocritical Care Society, Chinese guidelines) using a systematic approach including: comprehensive evidence review, multidisciplinary expert panel input, regional implementation barrier assessment, and formal consensus procedures. Recommendations employ MENA-SINO's framework with modified Class of Recommendation, Level of Evidence, Resource-Limited designations, and Expert Opinion statements where appropriate.

Key Recommendations: Our regional roadmap emphasizes: (1) telemedicine networks to overcome geographical barriers to specialized care; (2) early aneurysm treatment with protocols for settings where transfer is delayed; (3) balanced approach to treatment modality selection considering variable regional expertise; (4) tiered management of medical complications adapted to different resource levels; (5) pragmatic seizure management considering medication accessibility; (6) standardized neurological monitoring protocols across all settings; (7) approaches to optimize nimodipine administration despite supply challenges; (8) blood pressure management adapted to variable monitoring capabilities; (9) individualized follow-up imaging based on local resource availability; and (10) multidisciplinary rehabilitation with family-centered approaches where formal services are limited. Conclusion: These guidelines provide a resource-stratified framework for aSAH management across the MENA region, with practical adaptations that address the realities of diverse healthcare settings while preserving essential care components. Implementation priorities and cost-effectiveness considerations further enhance their practical utility.