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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Detecting and treating microvascular ischemia after subarachnoid hemorrhage
Oliver W Sakowitz1, Andreas W Unterberg
1Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany.
Current Opinion in Critical Care
|March 18, 2006
Summary
Early detection and management of cerebral vasospasm after subarachnoid hemorrhage are crucial. Treatment involves nimodipine prophylaxis and therapeutic hypertension, hypervolemia, and hemodilution (HHH), with ongoing research into new therapies.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Cerebral vasospasm is a common complication following subarachnoid hemorrhage.
- Delayed ischemia significantly contributes to morbidity and mortality.
Purpose of the Study:
- To review current management strategies for cerebral vasospasm post-subarachnoid hemorrhage.
- To highlight detection and treatment of delayed ischemic complications.
Main Methods:
- Review of sensitive and specific monitoring techniques for early vasospasm detection.
- Evaluation of prophylactic and therapeutic interventions.
- Assessment of endovascular treatment options.
Main Results:
- Nimodipine is a standard prophylactic agent.
- Therapeutic hypertension, hypervolemia, and hemodilution (HHH) improve outcomes.
- Endovascular therapies offer options for refractory cases but have risks.
Conclusions:
- Diagnosis integrates clinical, non-invasive, and invasive monitoring.
- Prophylactic nimodipine and therapeutic HHH are key components of management.
- Novel causal therapies are under investigation.
