[The prevention and treatment of vasospasm in subarachnoid hemorrhage]

The overall data concerning the incidence of angiographic and clinical vasospasm are reported. Furthermore, the pathogenetic mechanisms of vasospasm with regard to vasotoxic agents, vasogenic agents and CSF blockage are discussed together with the mechanisms affecting platelet aggregation, decrease of prostacyclins, and increase of endothelin. At present, therapeutic golden standard, i.e. (triple H therapy), calcium-antagonist, fibrinolytics and antioxidizing agents are debated concerning their clinical applications, first, during and after any possible surgical or endovascular treatment of the source of bleeding, i.e., the aneurysm.