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Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care.

Publication ,  Journal Article
Treggiari-Venzi, MM; Suter, PM; Romand, JA
Published in: Neurosurgery
February 2001

Cerebral vasospasm remains a devastating medical complication of aneurysmal subarachnoid hemorrhage (SAH). It is associated with high morbidity and mortality rates, even after the aneurysm has been secured surgically or radiologically. A great deal of experimental and clinical research has been conducted in an effort to find ways to prevent this complication. The literature includes extensive coverage of in vivo animal model studies of SAH and vasospasm. These experimental studies have contributed to tremendous advances in the understanding of the mechanisms leading to cerebral vasospasm. Most of the experimental settings, however, have demonstrated varying levels of ability to predict accurately what occurs in human SAH. Therefore, although animal models have been developed to test new therapies, most of the treatment effects have been shown to be less compelling when trials have been conducted in clinical settings. The interpretation of current literature is complicated further by the imprecise estimation of the incidence of cerebral vasospasm, which is due to various degrees of clinical expression, ranging from the absence of symptoms in the presence of increased blood flow velocities at transcranial Doppler or vessel diameter reduction at angiography to neurological manifestations of severe ischemic deficits. In addition, a change over time in the incidence pattern of human SAH and vasospasm, possibly related to improved surgical techniques and overall patient management, may have occurred. This topic review collects the relevant literature on clinical trials investigating prophylactic therapies for cerebral vasospasm in patients with aneurysmal SAH and emphasizes the need for large clinical trials to confirm the results derived from clinical experience. In addition, it points out some experimental therapies that may hold promise in future clinical trials to prevent the occurrence of vasospasm.

Duke Scholars

Published In

Neurosurgery

DOI

ISSN

0148-396X

Publication Date

February 2001

Volume

48

Issue

2

Start / End Page

249 / 261

Location

United States

Related Subject Headings

  • Vasospasm, Intracranial
  • Subarachnoid Hemorrhage
  • Neurology & Neurosurgery
  • Intracranial Aneurysm
  • Humans
  • Critical Care
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Treggiari-Venzi, M. M., Suter, P. M., & Romand, J. A. (2001). Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care. Neurosurgery, 48(2), 249–261. https://doi.org/10.1097/00006123-200102000-00001
Treggiari-Venzi, M. M., P. M. Suter, and J. A. Romand. “Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care.Neurosurgery 48, no. 2 (February 2001): 249–61. https://doi.org/10.1097/00006123-200102000-00001.
Treggiari-Venzi MM, Suter PM, Romand JA. Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care. Neurosurgery. 2001 Feb;48(2):249–61.
Treggiari-Venzi, M. M., et al. “Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care.Neurosurgery, vol. 48, no. 2, Feb. 2001, pp. 249–61. Pubmed, doi:10.1097/00006123-200102000-00001.
Treggiari-Venzi MM, Suter PM, Romand JA. Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care. Neurosurgery. 2001 Feb;48(2):249–261.
Journal cover image

Published In

Neurosurgery

DOI

ISSN

0148-396X

Publication Date

February 2001

Volume

48

Issue

2

Start / End Page

249 / 261

Location

United States

Related Subject Headings

  • Vasospasm, Intracranial
  • Subarachnoid Hemorrhage
  • Neurology & Neurosurgery
  • Intracranial Aneurysm
  • Humans
  • Critical Care
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences