Monitoring Hemodynamic Changes Related to Vasospasm in the Circle of Willis After Aneurysm Surgery
In the last ten years the microneurosurgical treatment of ruptured cerebral aneurysm has become safer, with an operative mortality of 5–7% (Yaşargil 1984). The aim of early surgery within 72 hours after subarachnoid hemorrhage (SAH) is to prevent rebleeding and to be able to start a postoperative medical treatment for vasospasm with hypertonia and/or hypervolemia. The mortality is mainly due to delayed ischemic deficits (DID) with 27% due to vasospasm (Kassell 1984). Because the real cause of vasospasm is not yet known, all therapeutic measures are symptomolytic: either the perfusion pressure of the brain is increased (hypertonia) or the resistance is decreased by preventing the arterial walls from contracting (calcium channel blocker nimodipine) (Allen 1983).
KeywordsMiddle Cerebral Artery Hemodynamic Change Pulse Repetition Frequency Pericallosal Artery Nimodipine Treatment
Unable to display preview. Download preview PDF.
- Fox JL, Ko JP (1978) Cerebral vasospasm: A clinical observation. Surg Neurol 10: 269–275Google Scholar
- Gilsbach JM (1983) Intraoperative Doppler sonography in neurosurgery. Springer, Wien New YorkGoogle Scholar
- Kassell NF, Tomer JC (1982) UnpubUshed observations from the cooperative aneurysm studyGoogle Scholar
- Kassell NF, Boarini DJ (1980) Patients with ruptured aneurysm: Pre- and postoperative management. In: Wilkins RA (ed) Cerebral arterial spasm. Williams and Wilkins, Baltimore LondonGoogle Scholar
- Kodama N, Mizoi K, Sakurai Y, Suzuki J (1980) Incidence and onset of vasospasm. In: Wilkins RA (ed) Cerebral arterial spasm. Williams and Wilkins, Baltimore LondonGoogle Scholar
- Yaşargil GM (1984) Microneurosurgery, vols I and I I. Thieme, Stuttgart New YorkGoogle Scholar