Abstract:
:Hemorrhagic infarction after vasospasm is a rare condition in patients with aneurysmal subarachnoid hemorrhage (SAH). Induced hypertensive therapy is used for patients with vasospasm, but this treatment has a risk of inducing hemorrhagic infarction. A total of 221 patients whose first computed tomographic (CT) scans were examined within 2 weeks after SAH were investigated for this study. There was symptomatic vasospasm in 99 (45%), cerebral infarction in 37 (17%), and hemorrhagic infarction in 13 (6%). Hemorrhagic infarction usually occurred 20 to 30 days after aneurysmal rupture; this period corresponds with the remission stage of the vasospasm. On CT scans, the hemorrhagic infarction was revealed as a leaky hemorrhage in a low density area in 11 cases, and a massive hemorrhage with mass effect was seen in 2 cases. These findings suggest that hemorrhagic infarction after vasospasm may sometimes be fatal. Cerebral blood flow autoregulation in patients with vasospasm was normal or of a hypertensive type during the remission stage of vasospasm, when hemorrhagic infarction usually appeared. This finding shows that induced hypertension therapy is ineffective during this stage; it should be stopped by this stage because it is ineffective and also may aggravate hemorrhagic infarction.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Terada T,Komai N,Hayashi S,Moriwaki H,Hyoutani G,Uematsu Y,Karasawa J,Kikuchi Hdoi
10.1227/00006123-198604000-00004subject
Has Abstractpub_date
1986-04-01 00:00:00pages
415-8issue
4eissn
0148-396Xissn
1524-4040journal_volume
18pub_type
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