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[Cerebral vasospasm. Clinicoangiographic correlation]

J Méndez, G Torrealba

    Acta Neurologica Latinoamericana
    |January 1, 1980
    PubMed
    Summary

    Cerebral vasospasm after aneurysmal subarachnoid hemorrhage correlates with neurological injury, particularly disorders of consciousness and motility. However, some patients show vasospasm without injury, suggesting individual susceptibility to spasmogenic substances.

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    Area of Science:

    • Neurology
    • Neurosurgery
    • Radiology

    Background:

    • Subarachnoid hemorrhage (SAH) from aneurysmal rupture is a critical neurological condition.
    • Cerebral vasospasm is a significant complication following SAH, leading to delayed ischemic deficits.
    • Understanding the clinicoangiographic correlation of cerebral vasospasm is crucial for patient management.

    Purpose of the Study:

    • To analyze the correlation between clinical presentation and angiographic findings of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.
    • To evaluate this correlation in pre-operative, post-operative, and follow-up periods.
    • To investigate the relationship between cerebral vasospasm and pathological findings.

    Main Methods:

    • A series of 120 patients with aneurysmal subarachnoid hemorrhage were studied.
    • Clinical grading used the Botterell classification modified by Hunt et al.
    • Cerebral vasospasm was classified using the criteria of Pool and Potts and Saito et al.
    • Patients underwent one to three angiographies in the pre- and post-operative courses.

    Main Results:

    • A good correlation was found between cerebral vasospasm and disorders of consciousness or motility in patients with neurological injury.
    • In 25% of Botterell grade I patients, cerebral vasospasm occurred without evident neurological injury.
    • The incidence of cerebral vasospasm was lower in patients with grades II-V, with clinical severity influenced by factors like hematoma and hydrocephalus.

    Conclusions:

    • Cerebral vasospasm in aneurysmal subarachnoid hemorrhage shows a correlation with neurological deficits, particularly consciousness and motility disturbances.
    • The occurrence of vasospasm without neurological injury in some cases suggests potential individual variability in susceptibility to spasmogenic substances.
    • Factors beyond vasospasm, such as hematoma and hydrocephalus, significantly impact clinical severity.

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