Management of cerebral vasospasm.

Abstract:

:Cerebral vasospasm is delayed narrowing of the large arteries of the circle of Willis occurring 4 to 14 days after aneurysmal subarachnoid hemorrhage (SAH). It is but one cause of delayed deterioration after SAH but, in general, is the most important potentially treatable cause of morbidity and mortality after SAH. Development of vasospasm is best predicted by the volume, location, persistence and density of subarachnoid clot early after SAH. Diagnosis is made by catheter angiography or, with less accuracy, by computed tomographic angiography, transcranial Doppler ultrasound or other methods. Treatment remains problematic because it is expensive, time-consuming, associated with substantial risk and largely ineffective. Treatment includes optimization of factors that affect cerebral blood flow and metabolism, systemic administration of nimodipine, hemodynamic therapy and pharmacologic and mechanical angioplasty.

journal_name

Neurosurg Rev

journal_title

Neurosurgical review

authors

Loch Macdonald R

doi

10.1007/s10143-005-0013-5

keywords:

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

179-93

issue

3

eissn

0344-5607

issn

1437-2320

journal_volume

29

pub_type

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