Abstract
Cerebral vasospasm is still one of the major causes of mortality and morbidity (M & M) in patients with subarachnoid hemorrhage (SAH) [1]. In spite of intense and extensive investigation over the past four decades, the optimal treatment of cerebral vasospasm has not yet been established. Clinical studies have clearly demonstrated the relationship between the location and volume of the subarachnoid clots and the incidence, distribution, and severity of vasospasm [3, 4, 11]. In 1988, Kodama et al reported that cisternal irrigation therapy with urokinase and ascorbic acid was effective in preventing cerebral vasospasm [5]. In 1990, Suzuki et al demonstrated that head-shaking method enhanced the fibrinolysis in cisternal irrigation [10]. In January 1994, we combined these two methods in order to achieve better outcome in Fisher CT group 3 patients and started cisternal irrigation therapy with urokinase combined with head-shaking, i.e., cisternal washing therapy.
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References
Dorsch NWC, King MT (1994) A review of cerebral vasospasm in aneurysmal subarachnoid hemorrhage. J Clin Neurosci 1: 19–26
Findlay JM, Kassell NF, Weir BKA, Haley EC Jr, Kongabel G, Germanson T, Truskowski L, Alves WM, Holnesso RO, Knuckey NW, Yonas H, Steinberg GK, West M, Winn HR, Ferguson G (1995) A randomized trial of intraoperative, intra-cisternal tissue plasminogen activator for the prevention of vasospasm. Neurosurgery 37: 168–178
Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scannning. Neurosurgery 6: 1–9
Fraser J, Johnson S, Ray M, Robertson JT (1980) Prediction of cerebral vasospasm with subarachnoid hemorrhage due to ruptured intracranial aneurysm by computerized tomography. Neurosurgery 6: 686–687
Kodama N, Sasaki T, Yamanobe K, Sato M, Kawakami M (1988) Prevention of vasospasm: cisternal irrigation therapy with urokinase and ascorbic acid. In: Wilkins (ed) Cerebral vaasospasm. Raven Press, New York, pp 415–418
Kodama N, Sasaki T, Kawakami M, Sato M, Asari J (2000) Cisternal irrigation therapy with urokinase and ascorbic acid for prevention of vasospasm after aneurysmal subarachnoid hemorrhage. Surg Neurol 53: 110–118
Mizoi K, Yoshimoto T, Takahashi A, Fujiwara S, Koshu K, Sugawara T (1993) Prospective study on the prevention of cerebral vasospasm by intrathecal fibrinolytic therapy with tissue-type plasminogen activator. J Neurosurg 78: 430–437
Ohman J, Servo A, Heiskanen O (1991) Effect of intrathecal fibrinolytic therapy on clot lysis and vasospasm in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg 75: 1970–201
Sasaki T, Ohta T, Kikuchi H, Takakura K, Usui M, Ohnishi H, Kondo A, Tanabe H, Nakamura J, Yamada K, Kobayashi N, Ohnishi Y (1994) A phase II clinical trial of recombinant human tissue-type plasminogen activator against cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Neurosurgery 35: 597–605
Suzuki I, Shimizu H, Takahashi H, Ishijima B (1990) Effect of head-shaking method on clot removal in cisternal irrigation. In: Sano K (ed) Cerebral vasospasm. University of Tokyo Press, Tokyo, pp 314–316
Suzuki J, Komatsu S, Sato T, Sakurai Y (1980) Correlation between CT findings and subsequent development of cerebral infarction due to vasospasm in subarachnoid hemorrhage. Acta Neurochir (Wien) 55: 63–70
Usui M, Saito N, Hoya K, Todo T (1994) Vasospasm prevention with postoperative intrathecal thrombolytic therapy. A retrospective comparison of urokinase, tissue plasminogen activator, and cisternal drainage alone. Neurosurgery 34: 235–245
Zabramski JM, Spetzler RF, Lee HKS, Papadopoulos SM, Bovill E, Zimmerman RS, Bederson JB (1991) Phase I trial of tissue plasminogen activator for the prevention of vasospasm in patients with aneurysmal subarachnoid hemorrhage. J Neuro-surg 75: 189–196
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© 2001 Springer-Verlag
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Nakagomi, T., Takagi, K., Narita, K., Nagashima, H., Tamura, A. (2001). Cisternal Washing Therapy for the Prevention of Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage. In: Seiler, R.W., Steiger, HJ. (eds) Cerebral Vasospasm. Acta Neurochirurgica Supplements, vol 77. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6232-3_34
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DOI: https://doi.org/10.1007/978-3-7091-6232-3_34
Publisher Name: Springer, Vienna
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