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Current management and treatment of cerebral vasospasm complicating SAH

Anna Luisa Kühn1, Joyce Saleh Balami, Iris Quasar Grunwald

  • 1Department of Radiology, University of Massachusetts, Worcester, MA, USA.

CNS & Neurological Disorders Drug Targets
|February 12, 2013
PubMed

Insights

Cerebral vasospasm following subarachnoid hemorrhage remains a major cause of death and disability. This review covers current and future treatments to prevent vasospasm-induced stroke after subarachnoid hemorrhage.

Area of Science:

  • Neurology
  • Neurosurgery
  • Vascular Neurology

Background:

  • Cerebral vasospasm is a significant complication of aneurysmal subarachnoid hemorrhage (aSAH).
  • It remains a primary cause of morbidity and mortality despite advances in aSAH treatment.
  • SAH-induced vasospasm leads to reduced cerebral perfusion, causing ischemia.

Purpose of the Study:

  • To review current therapeutic options for cerebral vasospasm post-SAH.
  • To discuss future strategies for reducing vasospasm-induced stroke.
  • To highlight diagnostic modalities for SAH-induced vasospasm.

Main Methods:

  • Review of current medical and endovascular therapies.
  • Discussion of diagnostic tools including transcranial doppler, digital subtraction angiography, CT, and MR.
  • Analysis of pathophysiology including vasculopathy, impaired autoregulation, and hypovolemia.

Main Results:

  • Cerebral vasospasm can be asymptomatic or symptomatic (delayed ischemic neurologic deficit).
  • Digital subtraction angiography is the gold standard for diagnosis, while transcranial doppler is a common screening tool.
  • Medical and endovascular therapies are current treatment mainstays.

Conclusions:

  • Effective management of cerebral vasospasm is crucial for improving outcomes after aSAH.
  • Further research into novel therapeutic approaches is needed to reduce stroke incidence.
  • Early diagnosis and timely intervention are key to mitigating neurological deficits.

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