Cerebral Vasospasms Following Subarachnoid Bleeding – Diagnosis, Monitoring and Treatment Options


Authors: J. Adamkov 1;  J. Náhlovský 1;  J. Habalová 1;  A. Krajina 2;  S. Řehák 1;  M. Kanta 1;  T. Česák 1
Authors‘ workplace: LF UK a FN Hradec Králové Neurochirurgická klinika 1;  LF UK a FN Hradec Králové Radiologická klinika 2
Published in: Cesk Slov Neurol N 2014; 77/110(2): 158-167
Category: Review Article

Podpořeno MZ ČR –  RVO (FNHK). Podpořeno programem PRVOUK P37/ 4.

Overview

Despite availability of sophisticated surgical procedures, endovascular techniques and new trends in neuro-intensive care, treatment outcomes in patients with subarachnoid bleeding from a ruptured aneurysm are still very unsatisfactory. The first step in patient management, i.e. treating the source of bleeding, is followed by close patient monitoring, taking into account the natural course of the disease. Cerebral vasospasms are among the most severe complications, identified in 40–70% of patients after subarachnoid bleeding. In patients in whom the source of bleeding has been treated, cerebral vasospasms are responsible for the development of delayed cerebral ischemia, the most common cause of high morbidity rates or deaths (15–20%). Effective prevention of such complications is based on detailed clinical observation. Invasive monitoring of cerebral metabolism and intracranial pressure is to be applied in patients with impaired consciousness in order to detect a threatening cerebral ischemia as early as possible. Current knowledge and technology enable more aggressive treatment that concentrates on normalising perfusion in the brain.

Key words:
cerebral vasospasms – subarachnoid haemorrhage – delayed cerebral ischemia

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


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