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Cerebral vasospasm: results of a structured multimodal treatment

E Keller1, N Krayenbühl, M Bjeljac

  • 1Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland. emanuela.keller@usz.ch

Acta Neurochirurgica. Supplement
|August 3, 2005
PubMed

Insights

Aggressive treatment of symptomatic cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) can improve outcomes. This multimodal approach achieved good functional results in 66% of patients with delayed ischemic neurologic deficits.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Symptomatic cerebral vasospasm (CVS) and delayed ischemic neurologic deficits (DIND) affect approximately one-third of patients post-aneurysmal subarachnoid hemorrhage (SAH).
  • The natural history of symptomatic CVS is devastating, necessitating aggressive treatment despite limited large-scale clinical trial evidence.

Purpose of the Study:

  • To evaluate the effectiveness of a structured, multimodal treatment protocol for symptomatic CVS and DIND following aneurysmal SAH.
  • To provide practical guidelines for managing symptomatic CVS based on clinical experience.

Main Methods:

  • Retrospective analysis of 79 cases with symptomatic CVS and DIND after aneurysmal SAH.
  • Implementation of a multidisciplinary treatment protocol involving neurosurgeons, interventional neuroradiologists, and neurointensive care specialists.

Main Results:

  • A good functional outcome was achieved in 66% of patients treated with the multimodal protocol.
  • The protocol emphasizes close and rapid multidisciplinary collaboration.

Conclusions:

  • An aggressive, structured multimodal treatment regimen is effective in improving functional outcomes for patients with symptomatic CVS and DIND after aneurysmal SAH.
  • Multidisciplinary collaboration is crucial for successful management.

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