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Cerebral arterial spasm--a clinical review
1Department of Neurosurgery, Westmead Hospital, Sydney, Australia.
British Journal of Neurosurgery
|January 1, 1995
Summary
Cerebral vasospasm affects over 67% of patients with aneurysmal subarachnoid hemorrhage (SAH), leading to significant disability or death. Early management strategies can improve outcomes for this critical condition.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Cerebral vasospasm is a common and serious complication following aneurysmal subarachnoid hemorrhage (SAH).
- It significantly impacts patient outcomes, contributing to delayed ischemic deficits, permanent neurological deficits, and mortality.
Purpose of the Study:
- To review the literature on the incidence, impact, and management of cerebral vasospasm after aneurysmal SAH.
- To highlight the effectiveness of various treatment modalities and identify areas for improved patient care.
Main Methods:
- Literature review of studies on cerebral vasospasm post-aneurysmal SAH.
- Analysis of reported incidence rates, clinical outcomes, and treatment strategies.
Main Results:
- Angiographic vasospasm occurs in 67.3% of cases, with symptomatic vasospasm in 32.6%.
- Vasospasm is associated with poor outcomes, including death (33%) and permanent deficit (33%) from delayed ischemia.
- Management strategies like fluid loading, induced hypertension, and calcium antagonists show promise in prevention and treatment.
Conclusions:
- Effective management strategies exist for cerebral vasospasm, including fluid loading, induced hypertension, calcium antagonists, and newer treatments.
- Despite available therapies, a significant number of patients do not receive specific treatment, underscoring the need for broader implementation of evidence-based care.