Cerebral Vasospasm: A Review

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
J Max FindlayTim Darsaut

Abstract

Cerebral vasospasm is a prolonged but reversible narrowing of cerebral arteries beginning days after subarachnoid hemorrhage. Progression to cerebral ischemia is tied mostly to vasospasm severity, and its pathogenesis lies in artery encasement by blood clot, although the complex interactions between hematoma and surrounding structures are not fully understood. The delayed onset of vasospasm provides a potential opportunity for its prevention. It is disappointing that recent randomized, controlled trials did not demonstrate that the endothelin antagonist clazosentan, the cholesterol-lowering agent simvastatin, and the vasodilator magnesium sulfate improve patient outcome. Minimizing ischemia by avoiding inadequate blood volume and pressure, administering the calcium antagonist nimodipine, and intervention with balloon angioplasty, when necessary, constitutes current best management. Over the past two decades, our ability to manage vasospasm has led to a significant decline in patient morbidity and mortality from vasospasm, yet it still remains an important determinant of outcome after aneurysm rupture.

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Citations

Nov 16, 2016·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Marcelo LannesJeanne Teitelbaum
Mar 31, 2018·Expert Opinion on Investigational Drugs·Roberta T TallaricoWilliam D Freeman
Nov 22, 2017·Journal of Cerebrovascular and Endovascular Neurosurgery·Eun-Sung ParkSung-Don Kang
Feb 9, 2019·Pharmacotherapy·Caroline Der-NigoghossianJason Makii
Apr 24, 2018·Journal of Neurosurgical Anesthesiology·Young SongDong Woo Han
Aug 20, 2019·Journal of Cardiovascular Pharmacology·Simon Topp ChristensenKristian Agmund Haanes
Oct 19, 2019·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Kyle P O'ConnorBradley N Bohnstedt
Apr 15, 2020·Pharmacogenomics·Courtney L JamesWilliam D Freeman
Apr 25, 2020·European Journal of Clinical Investigation·Aldo BonaventuraFabrizio Montecucco
Jun 12, 2020·Omics : a Journal of Integrative Biology·Tanavi SharmaHemant Bhagat
Jul 30, 2020·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Clint A BadgerHamza A Shaikh
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Oct 21, 2020·Translational Stroke Research·Sean N NeifertR Loch Macdonald
Apr 8, 2021·Expert Opinion on Pharmacotherapy·Tatsuya Maruhashi, Yukihito Higashi
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Aug 4, 2021·Clinical and Experimental Pharmacology & Physiology·Ying YuFan Chen
Nov 18, 2021·The Cochrane Database of Systematic Reviews·Mathias MaagaardJanus C Jakobsen

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