Cerebral vasospasm after subarachnoid hemorrhage: an update

Cerebral vasospasm is a significant problem after subarachnoid hemorrhage, with often devastating consequences. Its pathogenesis remains poorly understood despite extensive research. Owing to the lack of a clear etiology, medical treatment is still largely limited to triple-H therapy and calcium channel blockers, although newer treatments such as percutaneous transluminal angioplasty and papaverine infusion are becoming more common. Clinical symptoms are often first noted by the registered nurse, who must then alert the physician to the need for diagnostic workup and therapy. Caring for patients after subarachnoid hemorrhage requires awareness of the potential for the development of vasospasm, and knowledge of the steps necessary to ensure its timely diagnosis and treatment. This article will review the current body of knowledge as it pertains to vasospasm and outline the direction of ongoing research.