Current Management and Treatment of Cerebral Vasospasm Complicating SAH

Author(s): Anna Luisa Kuhn, Joyce Saleh Balami, Iris Quasar Grunwald.

Journal Name: CNS & Neurological Disorders - Drug Targets

Volume 12 , Issue 2 , 2013

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Abstract:

Cerebral vasospasm is a common and serious complication of aneurysmal subarachnoid haemorrhage. Despite the improvements in treatment of aneurysmal subarachnoid haemorrhage (aSAH), cerebral vasospasm complicating aSAH has remained the main cause of morbidity and mortality. Subarachnoid haemorrhage (SAH)-induced vasospasm is a complex entity caused by vasculopathy, impaired autoregulation, and hypovolaemia, causing a regional reduction of cerebral brain perfusion which can then induce ischaemia. Cerebral vasospasm can present either asymptomatically detected only radiologically or symptomatically (delayed ischaemic neurologic deficit). The various diagnostic approaches include the use of transcranial doppler, digital subtraction angiography and multimodal computed tomography (CT) and magnetic resonance (MR) techniques. Although digital subtraction angiography is usually the gold standard for the diagnosis of cerebral vasospam, transcranial doppler is commonly the first-screening method for the detection of cerebral vasospam. The treatment of subarachnoid haemorrhage -induced vasospasm include the use of both medical and endovascular therapy. The aim of this review is to discuss the various current therapeutic options and future perspective measures for reducing cerebral vasospasm induced stroke after SAH.

Keywords: Aneurysmal subarachnoid haemorrhage, cerebral vasospasm, diagnosis, endovascular therapy, transcranial doppler, medical therapy, Triple-H therapy.

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Article Details

VOLUME: 12
ISSUE: 2
Year: 2013
Page: [233 - 241]
Pages: 9
DOI: 10.2174/1871527311312020010
Price: $58

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