Skip to main content

Treatment of Post-hemorrhagic Cerebral Vasospasm: Role of Endovascular Therapy

  • Conference paper
Early Brain Injury or Cerebral Vasospasm

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 110/2))

Abstract

In this review, the current role of intracranial angioplasty and intra-arterial vasodilators for post-hemorrhagic vasospasm is described with an emphasis on the rationale for its use and the supporting data from published scientific and clinical studies. Current clinical indications and specific techniques are highlighted. Special attention is given to the evolution of these techniques over time. A discussion of acute and chronic complications, short and long-term treatment results, device specific trends and controversies are outlined.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. van Gijn J, Rinkel GJ. Subarachnoid haemorrhage: diagnosis, causes and management. Brain 2001;124:249–278.

    Article  PubMed  CAS  Google Scholar 

  2. Kassell NF, Sasaki T, Colohan AR, Nazar G. Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke 1985;16:562–572.

    Article  PubMed  CAS  Google Scholar 

  3. Turjman F, Mimon S, Yilmaz H. [Epidemiology, clinical study and pathology of vasospasm]. J Neuroradiol. 1999;26:S10–S16.

    PubMed  CAS  Google Scholar 

  4. Egge A, Waterloo K, Sjoholm H, Solberg T, Ingebrigtsen T, Romner B. Prophylactic hyperdynamic postoperative fluid therapy after aneurysmal subarachnoid hemorrhage: a clinical, prospective, randomized, controlled study. Neurosurgery 2001;49:593–605.

    PubMed  CAS  Google Scholar 

  5. Heros RC, Zervas NT, Varsos V. Cerebral vasospasm after subarachnoid hemorrhage: an update. Ann Neurol. 1983;14:599–608.

    Article  PubMed  CAS  Google Scholar 

  6. Kassell NF, Torner JC, Jane JA, Haley EC, Jr., Adams HP. The International Cooperative study on the timing of aneurysm surgery. Part 2: surgical results. J Neurosurg. 1990;73:37–47.

    Article  PubMed  CAS  Google Scholar 

  7. Kassell NF, Torner JC, Haley EC, Jr., Jane JA, Adams HP, Kongable GL. The International cooperative study on the timing of aneurysm surgery. Part 1: overall management results. J Neurosurg. 1990;73:18–36.

    Article  PubMed  CAS  Google Scholar 

  8. Solenski NJ, Haley EC, Jr., Kassell NF, Kongable G, Germanson T, Truskowski L, et al. Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Participants of the Multicenter Cooperative Aneurysm Study. Crit Care Med. 1995;23:1007–1017.

    Article  PubMed  CAS  Google Scholar 

  9. Dorsch NW, King MT. A review of cerebral vasospasm in aneurysmal subarachnoid haemorrhage Part I: incidence and effects. J Clin Neurosci. 1994;1:19–26.

    Article  PubMed  CAS  Google Scholar 

  10. Fisher CM. Clinical syndromes in cerebral thrombosis, hypertensive hemorrhage, and ruptured saccular aneurysm. Clin Neurosurg. 1975;22:117–147.

    PubMed  CAS  Google Scholar 

  11. Fisher CM, Roberson GH, Ojemann RG. Cerebral vasospasm with ruptured saccular aneurysm – the clinical manifestations. Neurosurgery 1977;1:245–1248.

    Article  PubMed  CAS  Google Scholar 

  12. Weir B, Grace M, Hansen J, Rothberg C. Time course of vasospasm in man. J Neurosurg. 1978;48:173–178.

    Article  PubMed  CAS  Google Scholar 

  13. Clark JF, Sharp FR. Bilirubin oxidation products (BOXes) and their role in cerebral vasospasm after subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2006;26:1223–1233.

    Article  PubMed  CAS  Google Scholar 

  14. Terry A, Zipfel G, Milner E, Cross DT, 3rd, Moran CJ, Diringer MN, et al. Safety and technical efficacy of over-the-wire balloons for the treatment of subarachnoid hemorrhage-induced cerebral vasospasm. Neurosurg Focus. 2006;21:E14.

    Article  PubMed  Google Scholar 

  15. Megyesi JF, Findlay JM, Vollrath B, Cook DA, Chen MH. In vivo angioplasty prevents the development of vasospasm in canine carotid arteries. Pharmacological and morphological analyses. Stroke 1997;28:1216–1224.

    Article  PubMed  CAS  Google Scholar 

  16. Yamamoto Y, Smith RR, Bernanke DH. Mechanism of action of balloon angioplasty in cerebral vasospasm. Neurosurgery 1992;30:1–5; discussion 5–6.

    Article  PubMed  CAS  Google Scholar 

  17. Mazumdar A, Rivet DJ, Derdeyn CP, Cross DT, 3rd, Moran CJ. Effect of intraarterial verapamil on the diameter of vasospastic intracranial arteries in patients with cerebral vasospasm. Neurosurg Focus. 2006;21:E15.

    Article  PubMed  Google Scholar 

  18. Firlik AD, Kaufmann AM, Jungreis CA, Yonas H. Effect of transluminal angioplasty on cerebral blood flow in the management of symptomatic vasospasm following aneurysmal subarachnoid hemorrhage. J Neurosurg. 1997;86:830–839.

    Article  PubMed  CAS  Google Scholar 

  19. Barker FG, 2nd, Ogilvy CS. Efficacy of prophylactic nimodipine for delayed ischemic deficit after subarachnoid hemorrhage: a metaanalysis. J Neurosurg. 1996;84:405–414.

    Article  PubMed  Google Scholar 

  20. Feigin VL, Rinkel GJ, Algra A, Vermeulen M, van Gijn J. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2000:CD000277.

    Google Scholar 

  21. Voldby B, Enevoldsen EM, Jensen FT. Cerebrovascular reactivity in patients with ruptured intracranial aneurysms. J Neurosurg. 1985;62:59–67.

    Article  PubMed  CAS  Google Scholar 

  22. Andaluz N, Tomsick TA, Tew JM, Jr., van Loveren HR, Yeh HS, Zuccarello M. Indications for endovascular therapy for refractory vasospasm after aneurysmal subarachnoid hemorrhage: experience at the University of Cincinnati. Surg Neurol. 2002;58:131–8; discussion 138.

    Article  PubMed  Google Scholar 

  23. McAuliffe W, Townsend M, Eskridge JM, Newell DW, Grady MS, Winn HR. Intracranial pressure changes induced during papaverine infusion for treatment of vasospasm. J Neurosurg. 1995;83:430–434.

    Article  PubMed  CAS  Google Scholar 

  24. Cross DT, 3rd, Moran CJ, Angtuaco EE, Milburn JM, Diringer MN, Dacey RG, Jr. Intracranial pressure monitoring during intraarterial papaverine infusion for cerebral vasospasm. AJNR Am J Neuroradiol. 1998;19:1319–1323.

    PubMed  Google Scholar 

  25. Elliott JP, Newell DW, Lam DJ, Eskridge JM, Douville CM, Le Roux PD, et al. Comparison of balloon angioplasty and papaverine infusion for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage. J Neurosurg. 1998;88:277–284.

    Article  PubMed  CAS  Google Scholar 

  26. Bejjani GK, Bank WO, Olan WJ, Sekhar LN. The efficacy and safety of angioplasty for cerebral vasospasm after subarachnoid hemorrhage. Neurosurgery 1998;42:979–86.

    Article  PubMed  CAS  Google Scholar 

  27. Eskridge JM, McAuliffe W, Song JK, Deliganis AV, Newell DW, Lewis DH, et al. Balloon angioplasty for the treatment of vasospasm: results of first 50 cases. Neurosurgery 1998;42:510–16; discussion 516–517.

    Article  PubMed  CAS  Google Scholar 

  28. Higashida RT, Halbach VV, Cahan LD, Brant-Zawadzki M, Barnwell S, Dowd C, et al. Transluminal angioplasty for treatment of intracranial arterial vasospasm. J Neurosurg. 1989;71:648–653.

    Article  PubMed  CAS  Google Scholar 

  29. Keuskamp J, Murali R, Chao KH. High-dose intraarterial verapamil in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2008;108:458–463.

    Article  PubMed  CAS  Google Scholar 

  30. Feng L, Fitzsimmons BF, Young WL, Berman MF, Lin E, Aagaard BD, et al. Intraarterially administered verapamil as adjunct therapy for cerebral vasospasm: safety and 2-year experience. AJNR Am J Neuroradiol. 2002;23:1284–1290.

    PubMed  Google Scholar 

  31. Muizelaar JP, Zwienenberg M, Rudisill NA, Hecht ST. The prophylactic use of transluminal balloon angioplasty in patients with Fisher Grade 3 subarachnoid hemorrhage: a pilot study. J Neurosurg. 1999;91:51–58.

    Article  PubMed  CAS  Google Scholar 

  32. Eskridge JM, Song JK. A practical approach to the treatment of vasospasm. AJNR Am J Neuroradiol. 1997;18:1653–1660.

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest statement We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mario Zuccarello .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag/Wien

About this paper

Cite this paper

Grande, A. et al. (2011). Treatment of Post-hemorrhagic Cerebral Vasospasm: Role of Endovascular Therapy. In: Feng, H., Mao, Y., Zhang, J.H. (eds) Early Brain Injury or Cerebral Vasospasm. Acta Neurochirurgica Supplements, vol 110/2. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0356-2_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-0356-2_23

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0355-5

  • Online ISBN: 978-3-7091-0356-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics