Traumatic cerebral vasospasms and secondary head injury

Traumatic cerebral vasospasm is a relatively frequent occurrence after an individual suffers a severe head injury, and therefore poses a real threat for these individuals. Although vasospasm is a physiologic defense response, it can cause a decrease in CBF, ischemia, infarction, and death. A review of the literature has indicated that hypervolemic and/or hypertensive therapy can increase cerebral perfusion and CBF pressure during cerebral vasospasms. Hypervolemic and hypertensive therapies, as well as the neurologic, pulmonary, and cardiovascular changes that can occur during traumatic cerebral vasospasms, pose a real challenge for the critical care nurse. The nurse must be a skilled clinician, able to detect subtle changes in the patient's condition, and also must constantly evaluate the current therapy.