Preliminary Experience with the Treatment of Intracranial Vasospasm by Transvascular Balloon Angioplasty
Microneurosurgical advances have greatly decreased the morbidity and mortality associated with ruptured intracranial aneurysms, particularly in patients with good clinical status. In patients with poor clinical status, the devastating effects of hemorrhage on the cerebral circulation can result in ischemia and infarction. Early neurosurgical clipping allows more aggressive postoperative management of delayed cerebral vasospasm with volume expansion and hypertension. Early surgery has shown a decreased incidence of delayed vasospasm if the clot surrounding the cerebral vasculature can be removed . In patients with delayed cerebral vasospasm with an untreated aneurysm, treatment with hypertension and volume expansion can increase the risk of rehemorrhage. In the United States, as many as 11% of patients with ruptured aneurysms will die secondary to the ischemic consequences of vasospasm, and considerably more will be permanently disabled .
KeywordsBasilar Artery Intracranial Aneurysm Cerebral Vasospasm Posterior Cerebral Artery Deep Coma
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Allen GS, Banghart SB (1979) Cerebral arterial spasm, Part 9: In vitro effects of nifedipine on serotonin-, phenylephrine-, and potassium-induced contractions of canine basilar and femoral arteries. Neurosurgery 4:37–47PubMedCrossRefGoogle Scholar
Cummins BH, Griffith HB (1971) Intracarotid phenoxybenzamine for cerebral arterial spasm. Br Med J 745:382–383CrossRefGoogle Scholar
Handa J, et al. (1973) Effect of intracarotid phenoxybenzamine on CBF and vasospasm: A clinical study. Surg Neurol 1:229–232PubMedGoogle Scholar
Hieshima GB, Higashida RT, Halbach VV, Cahan L, Goto K (1986) Intravascular balloon embolization of a carotid-ophthalmic artery aneurysm with preservation of the parent vessel. Am J Neuroradiol 7(5):916–918PubMedGoogle Scholar
Hieshima GB, Higashida RT, Wapenski J, Halbach V, Cahan L, Bentson J (1986) Balloon embolization of a large distal basilar artery aneurysm. J Neurosurg 65(3):413–416PubMedCrossRefGoogle Scholar
Ishii S, Chigasaki H, Nonaka T, et al. (1977) Clinical usefulness of haptoglobin in the treatment of vasospasm following SAH. Neurosurgery 1:65–66CrossRefGoogle Scholar
Kassell NF, Drake CG (1982) Timing of aneurysm surgery. Neurosurgery 10(4):515–519Google Scholar
Mizukami M, Kawase T, Usami T, et al. (1982) Prevention of vasospasm by early operation with removal of subarachnoid blood. Neurosurgery 10(3):301–307PubMedCrossRefGoogle Scholar
Sundt TM Jr, Onofro BM, Merideth J (1973) Treatment of cerebral vasospasm from subarachnoid hemorrhage with isoproterenol and lidocaine hydrochloride. J Neurosurg 38:557–560PubMedCrossRefGoogle Scholar
Zubkov TN, Nikitrov BM, Shuitin VA (1984) Balloon catheter technique for dilatation of constricted arteries after aneurysmal SAH. Acta Neurochir 70:65–79PubMedCrossRefGoogle Scholar