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[Hemorrhagic infarction following cerebral vasospasm]
1Department of Neurosurgery, Gifu University, School of Medicine, Japan.
No to Shinkei = Brain and Nerve
|October 1, 1989
Summary
Hemorrhagic infarction following vasospasm is a rare but serious complication of ruptured aneurysms. Induced hypertension therapy may increase the risk, suggesting alternative treatments and monitoring are needed.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Subarachnoid hemorrhage (SAH) from ruptured aneurysms can lead to delayed cerebral vasospasm.
- Vasospasm is a significant cause of secondary brain injury after SAH.
Observation:
- Hemorrhagic infarction occurred in 1.9% of 528 ruptured aneurysm cases, typically 9-25 days post-rupture.
- Neurological symptoms included worsening consciousness; CT scans showed heterogeneous or massive hemorrhages within infarcts.
- Massive hemorrhagic infarction correlated with poor prognosis.
Findings:
- Induced hypertension therapy for vasospasm was identified as a potential risk factor for hemorrhagic infarction.
- Treatment outcomes were generally unfavorable, with a high rate of poor outcomes or death, especially in massive cases.
Implications:
- Avoid induced hypertension therapy during the remission stage of vasospasm.
- Serial single-photon emission computed tomography (SPECT) studies may help estimate vasospasm severity and guide treatment.
- Further research into optimal vasospasm management is warranted to improve patient outcomes.