Aspects of the Medical Management in Aneurysmal Subarachnoid Hemorrhage

  • J. P. Castel
Part of the Advances and Technical Standards in Neurosurgery book series (NEUROSURGERY, volume 18)


The severity of an aneurysmal subarachnoid hemorrhage (SAH) is not only related to the direct effect of the initial bleeding, but also to the harmful effects of a number of complications occurring in the first two weeks after the ictus. During this time, careful monitoring of the patient and some medical adjuncts can either prevent the occurrence or limit the effects of these complications. Among them, recurrent hemorrhage from the aneurysm and delayed cerebral ischemia are two major events that can dramatically affect the final outcome. Prevention of rebleeding is assured by the surgical exclusion of the aneurysm, whenever possible. Prevention of delayed cerebral ischemia can only be provided by a medical management either pre- or postoperatively. Various drugs have been tried and most of them abandoned becaused of lack of effect. Recent data suggest a role for that calcium antagonists in the prevention of cerebral ischemic complications. Despite early prevention, however, symptoms of cerebral ischemia can occur and a vigorous treatment is needed to reduce the risks of cerebral infarction. The main goal of this treatment has not changed over the years: improvement of cerebral perfusion pressure and thereby of cerebral blood flow.


Cerebral Ischemia Subarachnoid Hemorrhage Intracranial Aneurysm Cerebral Vasospasm Aneurysmal Subarachnoid Hemorrhage 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abenerthy DR, Schwartz JB (1988) Pharmacokinetics of calcium antagonists under development. Clin Pharmacokinet 15: 1–14Google Scholar
  2. 2.
    Adams HP (1987) Antifibrinolytics in aneurysmal subarachnoid hemorrhage. Do they have a role? Maybe. Arch Neurol 44: 114–115PubMedGoogle Scholar
  3. 3.
    Adams HP Jr, Nibbelink DW, Tomer JC et al(1981) Antifibrinolytic therapy in patients with aneurysmal subarachnoid hemorrhage. A report of the cooperative aneurysm study. Arch Neurol 38: 25–29PubMedGoogle Scholar
  4. 4.
    Adams HP, Olinger CP, Barsan WG et al (1986) A dose-escalation study of large doses of naloxone for treatment of patients with acute cerebral ischemia. Stroke 17: 404–409PubMedGoogle Scholar
  5. 5.
    Allen GS, Ahn HS, Preziosi TJ et al (1983). Cerebral arterial spasm: a controlled trial of nimodipine in patients with subarachnoid hemorrhage. N Engl J Med 308: 619–624PubMedGoogle Scholar
  6. 6.
    Alvarez Garijo JA, Vilches Jf, Aznar JA (1980) Preoperative treatment of ruptured intracranial aneurysms with tranexamic acid and monitoring of fibrinolytic activity. J Neurosurg 52: 453–455PubMedGoogle Scholar
  7. 7.
    Ameen AA, Illingworth R (1981) Antifibrinolytic treatment in the pre-operative management of subarachnoid hemorrhage caused by ruptured intracranial aneurysm. J Neurol Neurosurg Psychiatry 44: 220–226PubMedGoogle Scholar
  8. 8.
    Andreoli A, di Pasquale G, Pinelli G et al (1987) Subarachnoid hemorrhage: frequency and severity of cardiac arrhythmias. A survey of 70 cases studied in the acute phase. Stroke 18: 558–564PubMedGoogle Scholar
  9. 9.
    Aoyagi N, Hayakawa I (1984) Analysis of 223 ruptured intracranial aneurysms with special reference to rerupture. Surg Neurol 21: 455–452Google Scholar
  10. 10.
    Arieff AI, Ilach F, Massry SG (1976) Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine 55: 121–129PubMedGoogle Scholar
  11. 11.
    Auer LM (1983) Acute surgery of cerebral aneurysms and prevention of symptomatic vasospasm. Acta Neurochir (Wien) 69: 273–281Google Scholar
  12. 12.
    Auer LM (1984) Acute operation and preventive nimodipine improve outcome in patients with ruptured cerebral aneurysms. Neurosurgery 15: 57–66PubMedGoogle Scholar
  13. 13.
    Auer LM, Brandt L, Ebeling U et al (1986) Nimodipine and early aneurysm operation for good conditions SAH patients. Acta Neurochir (Wien) 82: 7–13Google Scholar
  14. 14.
    Awad IA, Carter LP, Spetzler RF et al (1987) Clinical vasospasm after subarachnoid hemorrhage: response to hypervolemic hemodilution and arterial hypertension. Stroke 18: 365–372PubMedGoogle Scholar
  15. 15.
    Bailey RT, Young B, Rapp RP et al (1981) Theophylline toxicity after the use of aminophylline in the treatment of cerebral vasospasm. Neurosurgery 9: 722–724PubMedGoogle Scholar
  16. 16.
    Baskin DS, Hosobuschi Y (1981) Naloxone reversal of ischemic neurological deficits in man. Lancet 2: 272–275PubMedGoogle Scholar
  17. 17.
    Battista AF, Flamm ES, Golstein M et al (1976) Effect of dopamine-betahydroxylase inhibition on cerebral vasospasm in the cat. J Neurosurg 44: 168–172PubMedGoogle Scholar
  18. 18.
    Beck W, Adams HP, Flamm ES et al (1988) Combination of aminoprolc acid and nicardipine in the treatment of aneurysmal subarachnoid hemorrhage. Stroke 19: 63–67PubMedGoogle Scholar
  19. 19.
    Bell BA, Miller JD, Neto NGF et al (1985) Effect of naloxone on deficits after aneurysmal subarachnoid hemorrhage. Neurosurgery 16: 498–501PubMedGoogle Scholar
  20. 20.
    Bevan JA (1982) Selective action of diltiazem on cerebral vascular smooth muscle in the rabbit: antagonism on extrinsic but not intrinsic maintained tone. Am J Cardiol 49: 519–524PubMedGoogle Scholar
  21. 21.
    Bevan JA, Bevan RD (1988) Arterial wall changes in chronic cerebrovasospasm: in vitro and in vivo pharmacological evidence. Ann Rev Pharmacol Toxicol 28: 311–329Google Scholar
  22. 22.
    Blumenkopf B, Wilkins RH, Feldmann JM (1980) Cerebral vasospasm and delayed neurological deficit after aneurysm rupture despite administration of reserpine and kanamycin. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore/London, pp 518–524Google Scholar
  23. 23.
    Böker DK, Solymosi L, Wassmann H (1985) Immediate postangiographic intraarterial treatment of cerebral vasospasm after subarachnoid hemorrhage with nimodipine. Neurochirurgia (Stuttg) 28: 118–120PubMedGoogle Scholar
  24. 24.
    Brandt L, Andersson KE, Ljunggren B et al (1988) Cerebrovascular and cerebral effects of nimodipine-an update. In: Reulen HJ, Philippon J (eds) Prevention and treatment of delayed ischaemic dysfunction in patients with subarachnoid hemorrhage. Acta Neurochir (Wien) [Suppl] 45. Springer, Wien New York, pp 11–20Google Scholar
  25. 25.
    Brouwers PJAM, Wijdicks EFM, Hasan D et al (1989) Serial electrocardiographic recording in aneurysmal subarachnoid hemorrhage. Stroke 20: 1162–1167PubMedGoogle Scholar
  26. 26.
    Brown FD, Hanlon K, Mullan S (1978) Treatment of aneurysmal hemiplegia with dopamine and mannitol. J Neurosurg 49: 525–529PubMedGoogle Scholar
  27. 27.
    Brown JA, Wollmann RL, Mullan S (1982) Myopathy induced by e-aminocaproïc acid. J Neurosurg 57: 130–134PubMedGoogle Scholar
  28. 28.
    Burchiel KJ, Hoffman JM, Bakay RAE (1984) Quantitative determination of plasma fibrinolytic activity in patients with ruptured intracranial aneurysms who are receiving e-aminocaprolc acid: relationship of possible complications of therapy to the degree of fibrinolytic activity. Neurosurgery 14: 57–63PubMedGoogle Scholar
  29. 29.
    Chimowitz MI, Pessin MS (1987) Is there a role for heparin in the management of complications of subarachnoid hemorrhage? Stroke 18: 1169–1172PubMedGoogle Scholar
  30. 30.
    Chyatte D, Fode NC, Nicholas DA et al (1987) Preliminary report: effects of high dose methylprednisolone on delayed cerebral ischemia in patients at high risk for vasospasm after subarachnoid hemorrhage. Neurosurgery 21: 157–160PubMedGoogle Scholar
  31. 31.
    Chyatte D, Rusch N, Sundt TM (1983) Prevention of chronic experimental vasospasm with ibuprofen and high dose methylprednisolone. J Neurosurg 59: 925–932PubMedGoogle Scholar
  32. 32.
    Chyatte D, Sundt TM (1984) Response of chronic experimental cerebral vasospasm to methylprenisolone and dexamethasone. J Neurosurg 60: 923–926PubMedGoogle Scholar
  33. 33.
    Cort JH (1954) Cerebral salt wasting. Lancet 1: 752–754Google Scholar
  34. 34.
    Crompton MR (1963) Hypothalamic lesions following the rupture of cerebral berry aneurysms. Brain 86: 301–314PubMedGoogle Scholar
  35. 35.
    Cruickshank JM, Neil-Dwyer G, Brice J (1974) Electrocardiographic changes and their prognostic significance in subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry 37: 755–759Google Scholar
  36. 36.
    Cruickshank JM, Neil-Dwyer G, Stott AW (1975) Possible role of oral propanolol upon the ECG changes occurring in subarachnoid hemorrhage. Cardiovasc Res 9: 236–245PubMedGoogle Scholar
  37. 37.
    Davis DH, Sundt TM (1980) Relationship of cerebral blood flow to cardiac output, mean arterial blood pressure, blood volume, and alpha and beta blockade in cats. J Neurosurg 52: 745–754PubMedGoogle Scholar
  38. 38.
    Decaux G, Unger J, Brimioulle S et al (1982) Hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone. Rapid correction with urea, sodium chloride, and water restriction therapy. JAMA 247: 471–474PubMedGoogle Scholar
  39. 39.
    Denny-Brown D (1951) The treatment of recurrent cerebrovascular symptoms and the question of “vasospasm”. Med Clin North Am 35: 1457–1474PubMedGoogle Scholar
  40. 40.
    Diringer M, Ladenson PW, Stern BJ et al (1988) Plasma atrial natriuretic factor and subarachnoid hemorrhage. Stroke 19: 1119–1124PubMedGoogle Scholar
  41. 41.
    Diringer M, Ladenson PW, Borel C (1989) Sodium and water regulation in a patient with cerebral salt wasting. Arch Neurol 46: 928–930PubMedGoogle Scholar
  42. 42.
    Doczi T, Bende J, Huska E et al (1981) Syndrome of inappropriate secretion of antidiuretic hormone after subarachnoid hemorrhage. Neurosurgery 9: 394–397PubMedGoogle Scholar
  43. 43.
    Doczi T, Joo F, Vecsernyes M et al (1988) Increased concentration of atrial natriuretic factor in the cerebrospinal fluid in patients with aneurysmal subarachnoid hemorrhage and raised intracranial pressure. Neurosurgery 23: 16–19PubMedGoogle Scholar
  44. 44.
    Dorsch NWC, Branston NM, Harris RJ et al (1989) An experimental study of the effect of Nimodipine in primate subarachnoid hemorrhage. Acta Neurochir (Wien) 99: 65–75Google Scholar
  45. 45.
    Dorsch NWC, Little JM (1989) Reference: Nimodipine in cerebral vasospasm. Neurosurgery 24: 959–960PubMedGoogle Scholar
  46. 46.
    Doshi R, Neil-Dwyer G (1980) A clinicopathological study of patients following subarachnoid hemorrhage. J Neurosurg 52: 295–301PubMedGoogle Scholar
  47. 47.
    Estañol B, Aguilar F, Corona T (1985) Diagnosis of reversible versus irreversible cerebral ischemia by the intravenous administration of naloxone. Stroke 16: 1006–1009PubMedGoogle Scholar
  48. 48.
    Estañol BV, Badui Dergal E, Cesarman E et al (1979) Cardiac arrhythmias associated with subarachnoid hemorrhage: prospective study. Neurosurgery 5: 675–680Google Scholar
  49. 49.
    Estañol BV, Loyo MV, Mateos JH et al (1977) Cardiac arrhythmias in experimental subarachnoid hemorrhage. Stroke 8: 440–447PubMedGoogle Scholar
  50. 50.
    Faden AI (1984) Opiate antagonists in the treatment of stroke. Stroke 15: 575–578PubMedGoogle Scholar
  51. 51.
    Farhat SM, Schneider RC (1967) Observations on the effect of systemic blood pressure on intracranial circulation in patients with cerebrovascular insufficiency. J Neurosurg 27: 441–445PubMedGoogle Scholar
  52. 52.
    Flamm ES (1980) Treatment of cerebral vasospasm with aminophylline and isoproterenol. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 575-577Google Scholar
  53. 53.
    Flamm ES, Adams HP, Beck DW et al (1988) Dose-escalation study of intravenous nicardipine in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg 68: 393–400PubMedGoogle Scholar
  54. 54.
    Flamm ES, Adams HP (1988) Intravenous nicardipine in patients with aneurysmal subarachnoid hemorrhage. In: Wilkins RH (ed) Cerebral vasospasm. Raven Press, New York, pp 495–502Google Scholar
  55. 55.
    Flamm ES, Ransohoff J (1976) Treatment of cerebral vasospasm by control of cyclic adenosine monophosphate. Surg Neurol 6: 223–226PubMedGoogle Scholar
  56. 56.
    Fleckenstein A (1983) History of calcium antagonists. Circ Res 52 [Suppl 1]: 3–16Google Scholar
  57. 57.
    Fleischer AG, Raggio JF, Tindall GT (1977) Aminophylline and isoproterenol in the treatment of cerebral vasospasm. Surg Neurol 8: 286–290Google Scholar
  58. 58.
    Fleischer AS, Tindall GT (1980) Cerebral vasospasm following aneurysm rupture: a protocol for therapy and prophylaxis. J Neurosurg 52: 149–152PubMedGoogle Scholar
  59. 59.
    Fodstad H (1982) Antifibrinolytic treatment in subarachnoid hemorrhage: present state. Acta Neurochir (Wien) 63: 233–244Google Scholar
  60. 60.
    Fodstad H, Forssell A, Lilequiest B et al (1978) Tranexamic acid in the preoperative management of ruptured intracranial aneurysms. Surg Neurol 10: 9–15PubMedGoogle Scholar
  61. 61.
    Fodstad H, Pilbrant A, Schannong M et al (1981) Determination of tranexamic acid and fibrin/fibrinogen degradation products in cerebrospinal fluid after aneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 58: 1–13Google Scholar
  62. 62.
    Fox JL, Falik JL, Shalhoub RJ (1971) Neurosurgical hyponatremia: the role of inappropriate antidiuresis. J Neurosurg 34: 506–514PubMedGoogle Scholar
  63. 63.
    Frazee JG, Bevan JA, Bevan RD et al (1988) Early treatment with diltiazem reduces delayed cerebral vascular narrowing after subarachnoid hemorrhage. Neurosurgery 23: 611–615PubMedGoogle Scholar
  64. 64.
    Frazee JG, Bevan JA, Bevan RD et al (1985) Effect of diltiazem on experimental chronic cerebral vasospasm in the monkey. J Neurosurg 62: 912–917PubMedGoogle Scholar
  65. 65.
    Fujita S, Kawaguchi T, Shose Y et al. (1990) Flunarizine treatment in poorgrade aneurysm patients. Acta Neurochir (Wien) 103: 11–17Google Scholar
  66. 66.
    George B, Muzard O, Begue T et al (1984) Efficacité d’un traitement médical (isoprotérénol + aminophylline) du spasme des ruptures anévrysmales. Neurochirurgie 30: 273–276PubMedGoogle Scholar
  67. 67.
    Giannotta SL, McGillicudy JE, Kindt GW (1977) Diagnosis and treatment of postoperative vasospasm. Surg Neurol 8: 286–290PubMedGoogle Scholar
  68. 68.
    Gilsbach JM (1988) Nimodipine in the prevention of ischaemic deficits after aneurysmal subarachnoid hemorrhage. An analysis of recent clinical studies. In: Reulen HJ, Philippon J (eds) Prevention and treatment of delayed ischaemic dysfunction in patients with subarachnoid hemorrhage. Acta Neurochir (Wien) [Suppl] 45. Springer, Wien New York, pp 41–50Google Scholar
  69. 69.
    Gilsbach JM, Harders AG (1989) Morbidity and mortality after early aneurysm surgery-a prospective study with nimodipine prevention. Acta Neurochir (Wien) 96: 1–7Google Scholar
  70. 70.
    Glick R, Green D, Ts’ao CH et al (1981) High-dose e-aminocaprolc acid prolongs the bleeding time and increases rebleeding and intraoperative hemorrhage in patients with subarachnoid hemorrhage. Neurosurgery 9: 398–401PubMedGoogle Scholar
  71. 71.
    Goetz KL (1988) Physiology and pathophysiology of atrial peptides. Am J Physiol 254: E1–E15PubMedGoogle Scholar
  72. 72.
    Gottstein U, Paulson OB (1972) The effect of intracarotid aminophylline infusion on the cerebral circulation. Stroke 3: 560–565PubMedGoogle Scholar
  73. 73.
    Grotenhuis JA, Bettag W, Fiebach BJO et al (1984) Intracarotid slow bolus injection of nimodipine during angiography for treatment of cerebral vasospasm. J Neurosurg 61: 231–240PubMedGoogle Scholar
  74. 74.
    Grotta JC (1987) Current status of hemodilution in acute cerebral ischemia. Stroke 18: 689–690PubMedGoogle Scholar
  75. 75.
    Grubb RL, Raichle ME, Eichling JO et al (1977) Effects of subarachnoid hemorrhage on cerebral blood volume, blood flow and oxygen utilization in humans. J Neurosurg 46: 446–453PubMedGoogle Scholar
  76. 76.
    Haraguchi S, Ebina K (1982) Evaluation of the dopamine induced hypertension therapy for vasospasm. Neurol Surg 10: 279–282Google Scholar
  77. 77.
    Harper AM, Craigen L, Kasda S (1981) Effect of calcium antagonist, nimodipine, on cerebral blood flow and metabolism in the primate. J Cereb Blood Flow Metab 1: 349–356PubMedGoogle Scholar
  78. 78.
    Hart RG, Byer JA, Slaughter JR et al (1981) Occurrence and implications of seizures in subarachnoid hemorrhage due to ruptured intracranial aneurysms. Neurosurgery 8: 417–421PubMedGoogle Scholar
  79. 79.
    Hasan D, Lindsay KW, Widjicks EFM et al (1989) Effect of fludrocortisone acetate in patients with subarachnoid hemorrhage. Stroke 20: 1156–1161PubMedGoogle Scholar
  80. 80.
    Hasan D, Vermeulen M, Wijdicks EFM et al (1989) Effect of fluid intake and hypertensive treatment on cerebral ischemia after subarachnoid hemorrhage. Stroke 20: 1511–1515PubMedGoogle Scholar
  81. 81.
    Hashi K, Matsuoka Y, Matsumoto Y et al (1980) Treatment of cerebral vasospasm with large doses of hydrocortisone. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 611–618Google Scholar
  82. 82.
    Hashi K, Tabaka K (1980) Barbiturate coma for severe brain ischemia due to cerebral vasospasm. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 637–645Google Scholar
  83. 83.
    The Hemodilution in Stroke Study Group (1989) Hypervolemic hemodilution treatment of acute stroke: results of a randomized multicentric trial using Pentastarch. Stroke 20: 317–323Google Scholar
  84. 84.
    Heros RC, Korosue K (1989) Hemodilution for cerebral ischemia. Stroke 20: 423–427PubMedGoogle Scholar
  85. 85.
    Higuchi S, Shiobara Y (1980) Comparative pharmacokinetics ofnicardipine hypochloride, a new vasodilator, in various species. Xenobiotica 10: 447–454PubMedGoogle Scholar
  86. 86.
    Hijdra A, Vermeulen M, van Gijn J et al (1984) Respiratory arrest in subarachnoid hemorrhage. Neurology 34: 1501–1503PubMedGoogle Scholar
  87. 87.
    Hillman J, v. Essen C, Lezniewski W (1988) Results of treatment for cerebral saccular aneurysms in a small neurosurgical unit. Evaluation of early operation and nimodipine treatment. Acta Neurochir (Wien) 94: 28–31Google Scholar
  88. 88.
    Hino A, Mizukawa N, Tenjin H et al (1989) Postoperative hemodynamic and metabolic changes in patients with subarachnoid hemorrhage. Stroke 20: 1504–1510PubMedGoogle Scholar
  89. 89.
    Höllerhage HG, Gaab MR, Zumkeller M et al (1988) The influence of nimodipine on cerebral blood flow autoregulation and blood-brain barrier. J Neurosurg 69: 919–922PubMedGoogle Scholar
  90. 90.
    Italian Acute Stroke Study Group (1988) Haemodilution in acute stroke: results of the Italian haemodilution trial. The Lancet 13: 318–321Google Scholar
  91. 91.
    Jan M, Buchheit F, Tremoulet M (1988) Therapeutic trial of intravenous nimodipine in patients with established cerebral vasospasm after rupture of intracranial aneurysms. Neurosurgery 23: 154–157PubMedGoogle Scholar
  92. 92.
    Joynt RJ, Afifi A, Hardison J (1965) Hyponatremia in subarachnoid hemorrhage. Arch Neurol 13: 633–638PubMedGoogle Scholar
  93. 93.
    Kapp J, Neill WR, Salter JE et al (1987) Systemic heparin in the early management of ruptured intracranial aneurysms: review of 104 consecutive cases and comparison with concurrent controls. Neurosurgery 20: 564–570PubMedGoogle Scholar
  94. 94.
    Kapp JP, Clower BR, Azar FM et al (1985) Heparin reduces proliferative angiopathy following subarachnoid hemorrhage in cats. J Neurosurg 62: 570–575PubMedGoogle Scholar
  95. 95.
    Kassell NF, Peerless SJ, Drake CG et al (1980) Treatment of ischemic deficits from cerebral vasospasm with high dose barbiturate therapy. Neurosurgery 7: 593–597PubMedGoogle Scholar
  96. 96.
    Kassell NF, Peerless SJ, Durward QJ et al (1982) Treatment of ischemic deficits from vasospasm with intravascular volume expansion and induced arterial hypertension. Neurosurgery 11: 337–343PubMedGoogle Scholar
  97. 97.
    Kassell NF, Saski T, Colohan ART et al (1985) Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke 16: 562–572PubMedGoogle Scholar
  98. 98.
    Kassell NF, Torner JC, Adams HP Jr. (1984) Antifibrinolytic therapy in the acute period following aneurysmal subarachnoid hemorrhage: Preliminary observations from the cooperative aneurysm study. J Neurosurg 61: 225–230PubMedGoogle Scholar
  99. 99.
    Kaye AH, Brownbill D (1981) Postoperative intracranial pressure in patients operated on for cerebral aneurysms following subarachnoid hemorrhage. J Neurosurg 54: 726–732PubMedGoogle Scholar
  100. 100.
    Kazda S (1985) Pharmacology of nimodipine, a calcium antagonist with preferential cerebrovascular activity. Neurochirurgia 28: 70–73PubMedGoogle Scholar
  101. 101.
    Kazda S, Towart R (1981) Differences of the calcium antagonist nimodipine (BAY e 9736) and bencyclan on cerebral and peripheral vascular smooth muscle. Br J Pharmacol 72: 582–583Google Scholar
  102. 102.
    Keränen T, Tapaninaho A, Hernesniemi J et al (1985) Late epilepsy after aneurysms operations. Neurosurgery 17: 897–900PubMedGoogle Scholar
  103. 103.
    Kim DS, Kang JK, Song JU (1989) Flunarizine treatment in SAH patients. Session on Cerebrovascular Disorders: 9th International Congress of Neurological Surgery, pp Abstract 103056, p 63Google Scholar
  104. 104.
    Kindt GW, McGilliculdy J, Pritz M et al (1980) Hypertension and hypervolemia as therapy for patients with vasospasm. In: Wilkins RH (ed) Cerebral arterial spasm. Williams and Wilkins, Baltimore, pp 661–668.Google Scholar
  105. 105.
    Kita H, Shima K, Akiya I et al (1989) Hemorrheological effects of ticlopidine in the treatment of cerebral vasospasm after subarachnoid hemorrhage. Session on Cerebrovascular Disorders: 9th International Congress of Neurological Surgery, pp Abstract 103059, p 64Google Scholar
  106. 106.
    Knuckey NW, Stokes BAR (1982) Medical management of patients following a ruptured cerebral aneurysm with e-aminocaproic acid, kanamycine, and reserpine. Surg Neurol 17: 181–185PubMedGoogle Scholar
  107. 107.
    Koos WT, Perneczky A, Auer LM et al (1985) Nimodipine treatment of ischemic neurological deficits due to cerebral vasospasm after subarachnoid hemorrhage: clinical results of a multicenter study. Neurochirurgia (Stuttg) 28: 114–117PubMedGoogle Scholar
  108. 108.
    Kosnik EJ, Hunt WE (1976) Postoperative hypertension in the management of patients with intracranial arterial aneurysms. J Neurosurg 45: 148–154PubMedGoogle Scholar
  109. 109.
    Laine E, Bousquet C, Parquet-Gernez A (1978) Intérêt du bilan sanguin lipido-glucidique d’une part, de l’étude des fonctions plaquettaires d’autre part, dans la conduite du traitement des anévrysmes arteriels intracrâniens. Neurochirurgie 24: 239–246PubMedGoogle Scholar
  110. 110.
    Lester M, Nelson PB (1981) Neurological aspects of vasopressin release and the syndrome of inappropriate secretion of antidiuretic hormone. Neurosurgery 8: 735–740PubMedGoogle Scholar
  111. 111.
    Levy WJ, Bay JW, Sawhny B et al (1982) Aminophylline plus nitroprusside and dopamine for treatment of cerebral vasospasm: a preliminary report. J Neurosurg 56: 646–649PubMedGoogle Scholar
  112. 112.
    Lindsay KW (1987) Antifibrinolytic agents in subarachnoid hemorrhage. J Neurol 234: 1–8PubMedGoogle Scholar
  113. 113.
    Ljunggren B, Brandt L, Saveland H et al (1984) Outcome in 60 consecutive patients treated with early aneurysm operation and intravenous nimodipine. J Neurosurg 62: 864–873Google Scholar
  114. 114.
    Loeb HS, Khan M, Saudye A et al (1976) Acute hemodynamic effects of dobutamide and isoproterenol in patients with low cardiac failure. Circ Shock 3: 55–63Google Scholar
  115. 115.
    Marin J, Lobato RD, Rico ML et al (1981) Effect of pentobarbital on the reactivity of isolated human cerebral arteries. J Neurosurg 54: 521–524PubMedGoogle Scholar
  116. 116.
    Marion DW, Segal R, Thompson ME (1986) Subarachnoid hemorrhage and the heart. Neurosurgery 18: 101–106PubMedGoogle Scholar
  117. 117.
    Maroon JC, Nelson PB (1979) Hypovolemia in patients with subarachnoid hemorrhage: therapeutic implications. Neurosurgery 4: 223–226PubMedGoogle Scholar
  118. 118.
    Martin WRW, Baker RP, Grubb RL et al (1984) Cerebral blood volume, blood flow, and oxygen metabolism in cerebral ischemia and subarachnoid hemorrhage: an in-vivo study using positron emission tomography. Acta Neurochir (Wien) 70: 3–9Google Scholar
  119. 119.
    Maurice-Williams RS, Gordon VB, Sykes A (1980) Monitoring fibrinolytic activity in the cerebrospinal fluid after aneurysmal subarachnoid hemorrhage: a guide to the risk of rebleeding? J Neurol Neurosurg Psychiatry 43: 175–181PubMedGoogle Scholar
  120. 120.
    Mee EW, Dorrance DE, Lowe D et al (1988) Controlled study of nimodipine in aneurysm patients treated early after subarachnoid hemorrhage. Neurosurgery 22: 484–491PubMedGoogle Scholar
  121. 121.
    Mendelow AD, Dharker S, Patterson J et al (1986) The dopamine withdrawal test following surgery for intracranial aneurysms. J Neurol Neurosurg Psychiatry 49: 35–38PubMedGoogle Scholar
  122. 122.
    Messeter K, Brandt L, Ljunggren B et al (1987) Prediction and prevention of delayed ischemic dysfunction after aneurysmal subarachnoid hemorrhage and early operation. Neurosurgery 20: 548–553PubMedGoogle Scholar
  123. 123.
    Miyagi K, Ishijima B, Sato F et al (1984) Indication for the method of and result of the prophylactic use of barbiturate therapy (B-therapy) against cerebral infarct from cerebral arterial vasospasm due to ruptured aneurysm. Neurol Surg 12: 303–310Google Scholar
  124. 124.
    Montgomery EB, Grubb RL, Raichle ME (1981) Cerebral hemodynamics and metabolism in postoperative cerebral vasospasm and treatment with hypertensive therapy. Ann Neurol 9: 502–506PubMedGoogle Scholar
  125. 125.
    Muizelaar JP, Becker DP (1986) Induced hypertension for the treatment of cerebral ischemia after subarachnoid hemorrhage. Surg Neuro 125: 317–325Google Scholar
  126. 126.
    Muizelaar JP, Wei EP, Kontos HA et al (1986) Cerebral blood flow is regulated by changes in blood pressure and in blood viscosity alike. Stroke 17: 44–48PubMedGoogle Scholar
  127. 127.
    Mullan S, Beckman F, Vailati G et al (1964) An experimental approach to the problem of cerebral aneurysms. J Neurosurg 21: 838–845PubMedGoogle Scholar
  128. 128.
    Mullan S, Dawley J (1968) Antifibrinolytic therapy for intracranial aneurysms. J Neurosurg 28: 21–23PubMedGoogle Scholar
  129. 129.
    Neil-Dwyer G, Cruishank J, Stratton C (1986) β-blockers, plasma total creatinine kinase and creatinine kinase myocardial isoenzyme, and the prognosis of subarachnoid hemorrhage. Drugs 25: 163–168Google Scholar
  130. 130.
    Neil-Dwyer G, Walter P, Cruishank J et al (1983) β-Blockade in subarachnoid hemorrhage. Drugs 25 [Suppl 2]: 273–277Google Scholar
  131. 131.
    Nelson PB, Seif S, Gutai J et al (1984) Hypoatremia with natriuresis following subarachnoid hemorrhage in a monkey model. J Neurosurg 60: 233–237PubMedGoogle Scholar
  132. 132.
    Nelson PB, Seif SM, Maroon JC et al (1981) Hyponatremia in intracranial disease: perhaps not the syndrome of inappropriate secretion of antidiuretic hormone. J Neurosurg 55: 938–941PubMedGoogle Scholar
  133. 133.
    Nibbelink DW, Tomer JC, Henderson WC (1975) Intracranial aneurysms and subarachnoid hemorrhage. A cooperative study. Antifibrinolytic therapy in recent onset subarachnoid hemorrhage. Stroke 6: 622–629PubMedGoogle Scholar
  134. 134.
    Norlen G, Thulin CA (1969) The use of antifibrinolytic substance in ruptured intracranial aneurysms. Neurochirurgia (Stuttg) 12: 100–102PubMedGoogle Scholar
  135. 135.
    North JB, Penhall RK, Hanieh A et al (1983) Phenytoin and postoperative epilepsy. J Neurosurg 58: 672–677PubMedGoogle Scholar
  136. 136.
    Nosko M, Schulz R, Weir B et al (1988) Effects of vasospasm on levels of prostacyclin and thromboxane A2. Neurosurgery 22: 45–50PubMedGoogle Scholar
  137. 137.
    Nosko M, Weir B, Krueger C et al (1985) Nimodipine and chronic vasospasm in monkeys: Part 1. Clinical and radiological findings. Neurosurgery 16: 129–136PubMedGoogle Scholar
  138. 138.
    Ochiai C, Asano T, Takakura K (1982) Mechanisms of cerebral protection by pentobarbital and nizofenone correlated with the course of local cerebral blood flow changes. Stroke 13: 788–796PubMedGoogle Scholar
  139. 139.
    Öhman J, Heiskanen O (1988) Effect of nimodipine on the outcome of patients after aneurysmal subarachnoid hemorrhage and surgery. J Neurosurg 69: 683–686PubMedGoogle Scholar
  140. 140.
    Öhman J, Heiskanen O (1989) Timing of operation for ruptured supratentorial aneurysms: a prospective randomized study. J Neurosurg 70: 55–60PubMedGoogle Scholar
  141. 141.
    Olesen J, Hougard K, Hertz M (1978) Isoproterenol and propanolol: ability to cross the blood-brain barrier and effects on cerebral circulation in man. Stroke 9: 344–349PubMedGoogle Scholar
  142. 142.
    Park BE (1979) Spontaneous subarachnoid hemorrhage complicated by communicating hydrocephalus: an aminocaproic acid as a possible predisposing factor. Surg Neurol 11: 73–80PubMedGoogle Scholar
  143. 143.
    Petruk KC, West M, Mohr G et al (1988) Nimodipine treatment in the poorgrade aneurysm patients: results of a multicentre double-blind placebo-controlled trial. J Neurosurg 68: 505–517PubMedGoogle Scholar
  144. 144.
    Philippon J, Grob R, Dagreon F et al (1986) Prevention of vasospasm in subarachnoid hemorrhage. A controlled study with nimodipine. Acta Neurochir (Wien) 82: 110–114Google Scholar
  145. 145.
    Pickard JD, Murray GD, Illingworth R et al (1989) Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid hemorrhage: British aneurysm nimodipine trial. Br Med J 298: 636–642Google Scholar
  146. 146.
    Poungvarin N, Bhoopat W, Viriyavejakul A et al (1987) Effects of dexamethasone in primary supratentorial intracerebral hemorrhage. N Engl J Med 316: 1229–1233PubMedGoogle Scholar
  147. 147.
    Pritz MB, Giannotta SL, Kindt GW et al (1978) Treatment of patients with neurological deficits associated with cerebral vasospasm by intravascular volume expansion. Neurosurgery 3: 364–368PubMedGoogle Scholar
  148. 148.
    Quirion R (1988) Atrial natriuretic factors and the brain: an update. Trends Neurosci 11: 58–62PubMedGoogle Scholar
  149. 149.
    Ramirez-Lassepas M (1981) Antifibrinolytic therapy in subarachnoid hemorrhage caused by ruptured intracranial aneurysm. Neurology 31: 316–322PubMedGoogle Scholar
  150. 150.
    Rämsch KD, Ahr G, Tettenborn D et al (1985) Overview on pharmacokinetics of nimodipine in healthy volunteers and in patients with subarachnoid hemorrhage. Neurochirurgia 28: 74–78PubMedGoogle Scholar
  151. 151.
    Reeder RF, Harbaugh RE (1989) Administration of intravenous urea and normal saline for the treatment of hyponatremia in neurosurgical patients. J Neurosurg 70: 201–206PubMedGoogle Scholar
  152. 152.
    Ritchie WI, Weir B, Overton TR (1980) Experimental subarachnoid hemorrhage in the cynomolgus monkey: evaluation of treatment with hypertension, volume expansion, and ventilation. Neurosurgery 6: 57–62PubMedGoogle Scholar
  153. 153.
    Rodriguez Y Baena R, Gaetani P, Marzatico MS et al (1989) Effects of Nicardipine on the ex vivo release of eicosanoids after experimental subarachnoid hemorrhage. J Neurosurg 71: 903–908Google Scholar
  154. 154.
    Rosenfeld JV, Barnett GH, Sila CA et al (1989) The effect of subarachnoid hemorrhage on blood and CSF atrial natriuretic factor. J Neurosurg 71: 32–37PubMedGoogle Scholar
  155. 155.
    Rosenwasser RH, Delgado TE, Bucheit WA et al (1983) Control of hypertension and prophylaxis against vasospasm in cases of subarachnoid hemorrhage: a preliminary report. Neurosurgery 12: 658–661PubMedGoogle Scholar
  156. 156.
    Rudehill A, Olsson GL, Sundqvist K et al (1987) ECG abnormalities in patients with subarachnoid hemorrhage and intracranial tumors. J Neurol Neurosurg Psychiatry 50: 1375–1381PubMedGoogle Scholar
  157. 157.
    Saito I, Asano T, Ochiai C et al (1983) A double-blind clinical evaluation of the effect of Nizofenone (Y-9179) on delayed ischemic neurological deficits following aneurysmal rupture. Neurol Res 5: 29–47PubMedGoogle Scholar
  158. 158.
    Samson DS, Beyer CM (1980) Thiopental coma in the treatment of vasospasm-induced cerebral ischemia/infarction. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 634–645Google Scholar
  159. 159.
    Saunders FW (1986) Diltiazem: possible hematologic complications. Surg. Neurol 25: 82–84PubMedGoogle Scholar
  160. 160.
    Saveland H, Ljunggren B, Brandt L et al (1986) Delayed ischemic deterioration in patients with early aneurysm operation and intravenous nimodipine. Neurosurgery 18: 146–150PubMedGoogle Scholar
  161. 161.
    Sawaya R, Sonnino V, McLaurin RL et al (1983) Monitoring of antifibrinolytic therapy following subarachnoid hemorrhage. The importance of CSF fibrin/fibrinogen degradation products. J Neurosurg 58: 699–707PubMedGoogle Scholar
  162. 162.
    Sbeih I, Tamas LB, O’Laoire SA (1986) Epilepsy after operation for aneurysms. Neurosurgery 19: 784–788PubMedGoogle Scholar
  163. 163.
    Schwartz WB, Bennett W, Curelop S, Bartter FC (1957) A syndrome of renal sodium loss and hyponatremia probably resulting from inappropriate secretion of antidiuretic hormone. Am J Med 23: 529–542PubMedGoogle Scholar
  164. 164.
    Seiler RW, Reulen HJ, Huber P et al (1988) Outcome of aneurysmal subarachnoid hemorrhage in a hospital population: a prospective study including early operation, intravenous nimodipine, transcranial doppler. Neurosurgery 23: 598–604PubMedGoogle Scholar
  165. 165.
    Shaw MDM, Foy PM, Huber P et al (1985) Dipyridamole and postoperative ischemic deficits in aneurysmal subarachnoid hemorrhage. J Neurosurg 63: 699–703PubMedGoogle Scholar
  166. 166.
    Shimoda M, Yamada S, Yamamoto I et al (1989) Atrial natriuretic polypeptide in patients with subarachnoid hemorrhage due to aneurysmal rupture. Acta Neurochir (Wien) 97: 53–61Google Scholar
  167. 167.
    Siesjö BK (1984) Cerebral circulation and metabolism. J Neurosurg 60: 883–908PubMedGoogle Scholar
  168. 168.
    Singh BN (1986) The mechanism of action of calcium antagonists relative to their clinical applications. Br J Clin Pharmacol 21: 109S–121SPubMedGoogle Scholar
  169. 169.
    Solomon RA, Fink ME, Lennihan L (1988) Early aneurysm surgery and prophylactic hypervolemic hypertensive therapy for the treatment of aneurysmal subarachnoid hemorrhage. Neurosurgery 23: 699–704PubMedGoogle Scholar
  170. 170.
    Solomon RA, Post KD, McMurty JG III (1984) Depression of circulating blood volume in patients after subarachnoid hemorrhage: implications for the management of symptomatic vasospasm. Neurosurgery 15: 354–361PubMedGoogle Scholar
  171. 171.
    Sonnenblick EH, Frishman WH, Le Jemtel TH (1979) Dobutamide: a new synthetic cardioactive sympathetic amine. N Engl J Med 300: 17–21PubMedGoogle Scholar
  172. 172.
    Stober T, Anstätt Th, Sen S et al (1988) Cardiac arrhythmias in subarachnoid hemorrhage. Acta Neurochir (Wien) 93: 37–44Google Scholar
  173. 173.
    Sundt TM (1975) Management of ischemic complications after subarachnoid hemorrhage. J Neurosurg 43: 418–425PubMedGoogle Scholar
  174. 174.
    Sundt TM, Onofrio BM, Merideth J (1973) Treatment of cerebral vasospasm from subarachnoid hemorrhage with isoproterenol and lidocaIne hydrochloride. J Neurosurg 38: 557–559PubMedGoogle Scholar
  175. 175.
    Suzuki S, Iwabuchi T, Tanaka T et al(1985) Prevention of cerebral vasospasm with OKY-046, an imidazole derivative and a thromboxane syntetase inhibitor. A preliminary co-operative clinical study. Acta Neurochir (Wien) 77: 133–141Google Scholar
  176. 176.
    Suzuki S, Sobata E, Iwabuchi T (1981) Prevention of cerebral ischemic symptoms in cerebral vasospasm with Trapidil, an antagonist and selective synthesis inhibitor of thromboxane A2. Neurosurgery 9: 679–685PubMedGoogle Scholar
  177. 177.
    Symon L (1980) General conclusions: suggestions for further research. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 693–694Google Scholar
  178. 178.
    Tabbaa MA, Ramirez-Lassepas M, Snyder BD (1987) Aneurysmal subarachnoid hemorrhage presenting as cardiorespiratory arrest. Arch Intern Med 147: 1661–1662PubMedGoogle Scholar
  179. 179.
    Takaku A, Shindo K, Tanaka S et al (1979) Fluid and electrolyte disturbances in patients with intracranial aneurysms. Surg Neurol 11: 349–356PubMedGoogle Scholar
  180. 180.
    Takenaka T, Handa J (1979) Cerebrovascular effects of YC-93, a new vasodilator, in dogs, monkeys and human patients. Int J Clin Pharmacol Biopharm 17: 1–11PubMedGoogle Scholar
  181. 181.
    Takeuchi S, Koike T, Sasaki O et al (1989) Intracranial extradural pressure monitoring after direct operation on ruptured cerebral aneurysms. Neurosurgery 24: 878–883PubMedGoogle Scholar
  182. 182.
    Tanabe T, Lewis PJ, Itoh H et al (1988) Hypervolemic therapy without induced hypertension in patients with severe subarachnoid hemorrhage. In: Wilkins RH (ed) Cerebral vasospasm. Raven Press, New York, pp 421–424Google Scholar
  183. 183.
    Tanabe T, Saitoh T, Tachibana S et al (1982) Effect of hyperdynamic therapy on cerebral ischemia caused by vasospasm associated with subarachnoid hemorrhage. Acta Neurochir (Wien) 63: 291–296Google Scholar
  184. 184.
    Tani E, Maeda Y, Fukumori T et al (1984) Effect of selective inhibitor of thromboxane A2 synthetase on cerebral vasospasm after early surgery. J Neurosurg 61: 24–29PubMedGoogle Scholar
  185. 185.
    Tsementzis SA, Hitchcock ER, Meyer CHA (1990) Benefits and risks of antifibrinolytic therapy in the management of ruptured intracranial aneurysms. Acta Neurochir (Wien) 102: 1–10Google Scholar
  186. 186.
    Van Breeman C, Hwang OK, Meisheri KD (1981) The mechanism of inhibitory action of diltiazem on vascular smooth muscle contractility. J Pharmacol Exp Ther 218: 459–463Google Scholar
  187. 187.
    VanderArk GD, Pomerantz M (1973) Reversal of ischemic neurological signs by increasing the cardiac output. Surg Neurol 1: 257–258Google Scholar
  188. 188.
    Varsos VG, Liszciak TM, Hee Han D et al (1983) Delayed cerebral vasospasm is not reversible by aminophylline, nifedipine or papaverine in a “two hemorrhage” canine model. J Neurosurg 58: 11–17PubMedGoogle Scholar
  189. 189.
    Vasu MA, O’Keefe DD, Kapellakis GZ et al (1978) Myocardial oxygen consumption: effects of epinephrine, isoproterenol, dopamine, norepinephrine, and dobutamine. Am J Physiol 235: H237–H241PubMedGoogle Scholar
  190. 190.
    Vermeulen M, Lindsay KW, Murray GD et al (1984) Antifibrinolytic treatment in subarachnoid hemorrhage. N Engl J Med 311: 432–437PubMedGoogle Scholar
  191. 191.
    Vermeulen M, van Vliet HHDM, Lindsay KW et al (1985) Source of fibrin/fibrinogen degradation products in the CSF after subarachnoid hemorrhage. J Neurosurg 63: 573–577PubMedGoogle Scholar
  192. 192.
    Vinge E, Brandt L, Ljunggren B et al (1988) Thromboxane B2 levels in serum during continuous administration of nimodipine to patients with aneurysmal subarachnoid hemorrhage. Stroke 19: 644–647PubMedGoogle Scholar
  193. 193.
    Voldby B, Enevoldsen EM, Jensen FT (1985) Cerebrovascular reactivity in patients with ruptured intracranial aneurysms. J Neurosurg 62: 59–67PubMedGoogle Scholar
  194. 194.
    Voldby B, Enevoldsen EM, Jensen FT (1985) Regional CBF, intraventricular pressure, and cerebral metabolism in patients with ruptured intracranial aneurysms. J Neurosurg 62: 48–58PubMedGoogle Scholar
  195. 195.
    von Essen C, Zervas NT, Brown DR et al (1980) Local cerebral blood flow in the dog during intravenous infusion of dopamine. Surg Neurol 13: 181–188Google Scholar
  196. 196.
    Weinand ME, O’Boynick OL, Goetz KL (1989) A study of serum antidiuretic hormone and atrial natriuretic peptide levels in a series of patients with intracranial disease and hyponatremia. Neurosurgery 25: 781–785PubMedGoogle Scholar
  197. 197.
    Weir B (1987) Antifibrinolytics in subarachnoid hemorrhage. Do they have a role? No. Arch Neurol 44: 116–118Google Scholar
  198. 198.
    White RP, Robertson JT (1987) Pharmacodynamic evaluation of human cerebral arteries in the genesis of vasospasm. Neurosurgery 21: 523–531PubMedGoogle Scholar
  199. 199.
    Wijdicks EFM, Hasan D, Lindsay KW et al (1989) Short-term tranexamic acid treatment in aneurysmal subarachnoid hemorrhage. Stroke 20: 1674–1679PubMedGoogle Scholar
  200. 200.
    Wijdicks EFM, Vermeulen M, Hijdra A et al (1985) Hyponatremia and cerebral infarction in patients with ruptured intracranial aneurysms: is fluid restriction harmful? Ann Neurol 17: 137–140PubMedGoogle Scholar
  201. 201.
    Wilkins RH (1986) Attempts at the prevention or treatment of intracranial arterial spasm: an update. Neurosurgery 18: 808–825PubMedGoogle Scholar
  202. 202.
    Winn HR, Richardson AE, O’Brien W et al (1978) The long-term prognosis in untreated cerebral aneurysms. Ann Neurol 4: 418–426PubMedGoogle Scholar
  203. 203.
    Wise BL (1978) Syndrome of inappropriate antidiuretic hormone secretion after spontaneous subarachnoid hemorrhage: a reversible cause of clinical deterioration. Neurosurgery 3: 412–414PubMedGoogle Scholar
  204. 204.
    Wood JH, Simeone FA, Kron RE et al (1984) Experimental hypervolemic hemodilution: physiological correlations of cortical blood flow, cardiac output, and intracranial pressure with fresh blood viscosity and plasma volume. Neurosurgery 14: 709–723PubMedGoogle Scholar
  205. 205.
    Wood JH, Simeone FA, Fink EA et al (1983) Hypervolemic hemodilution in experimental focal cerebral ischemia. Elevation of cardiac output, regional cortical blood flow, and ICP after intravascular volume expansion with low molecular weight dextran. J Neurosurg 59: 500–509PubMedGoogle Scholar
  206. 206.
    Wood JH, Simeone FA, Kron RE et al (1982) Rheological aspects of experimental hypervolemic hemodilution with low molecular weight Dextran: relationships of cortical blood flow, cardiac output, and intracranial pressure to fresh blood viscosity and plasma volume. Neurosurgery 11: 739–753PubMedGoogle Scholar
  207. 207.
    Wood JH, Snyder LL, Simeone FA (1982) Failure of intravascular volume expansion without hemodilution to elevate cortical blood flow in region of experimental focal ischemia. J Neurosurg 56: 80–91PubMedGoogle Scholar
  208. 208.
    Yamakami I, Isobe K, Yamaura A (1987) Effects of intravascular volume expansion on cerebral blood flow in patients with ruptured cerebral aneurysms. Neurosurgery 21: 303–309PubMedGoogle Scholar
  209. 209.
    Yamamoto M, Ohta T, Toda N (1983) Mechanisms of relaxant action of nicardipine, a new Ca + + antagonist, on isolated dog cerebral and mesenteric arteries. Stroke 14: 270–275PubMedGoogle Scholar
  210. 210.
    Yamaura A, Nakamura T, Makino H et al (1980) Cerebral complication of antifibrinolytic therapy in the treatment of ruptured intracranial aneurysm. Animal experiment and a review of literature. Eur Neurol 19: 77–84PubMedGoogle Scholar
  211. 211.
    Yonas H, Sekhar L, Johnson DW et al (1989) Determination of irreversible ischemia by Xenon-enhanced computed tomographic monitoring of cerebral blood flow in patients with symptomatic vasospasm. Neurosurgery 24: 368–372PubMedGoogle Scholar
  212. 212.
    Young B, Rapp RP, Norton JA et al (1983) Failure of prophylactically administered phenytoin to prevent late posttraumatic seizures. J Neurosurg 58: 236–241PubMedGoogle Scholar
  213. 213.
    Zervas NT, Candia M, Candia G et al (1979) Reduced incidence of cerebral ischemia following rupture of intracranial aneurysms. Surg Neurol 11: 339–344PubMedGoogle Scholar
  214. 214.
    Zervas NT, Kistler JP, Ploetz J (1980) Effect of reserpine and kanamycin on postoperative delayed ischemic deficits in patients with subarachnoid hemorrhage after aneurysmal rupture. In: Wilkins RH (ed) Cerebral arterial spasm. Williams & Wilkins, Baltimore London, pp 514–517Google Scholar

Copyright information

© Springer-Verlag Wien 1991

Authors and Affiliations

  • J. P. Castel
    • 1
  1. 1.Clinique Universitaire de NeurochirurgieGroupe Hospitalier PellegrinBordeauxFrance

Personalised recommendations