Title:Current Management and Treatment of Cerebral Vasospasm Complicating SAH
Volume: 12
Issue: 2
Author(s): Anna Luisa Kuhn, Joyce Saleh Balami and Iris Quasar Grunwald
Affiliation:
Keywords:
Aneurysmal subarachnoid haemorrhage, cerebral vasospasm, diagnosis, endovascular therapy, transcranial doppler,
medical therapy, Triple-H therapy.
Abstract: Cerebral vasospasm is a common and serious complication of aneurysmal subarachnoid haemorrhage. Despite
the improvements in treatment of aneurysmal subarachnoid haemorrhage (aSAH), cerebral vasospasm complicating aSAH
has remained the main cause of morbidity and mortality. Subarachnoid haemorrhage (SAH)-induced vasospasm is a
complex entity caused by vasculopathy, impaired autoregulation, and hypovolaemia, causing a regional reduction of
cerebral brain perfusion which can then induce ischaemia. Cerebral vasospasm can present either asymptomatically
detected only radiologically or symptomatically (delayed ischaemic neurologic deficit). The various diagnostic
approaches include the use of transcranial doppler, digital subtraction angiography and multimodal computed tomography
(CT) and magnetic resonance (MR) techniques. Although digital subtraction angiography is usually the gold standard for
the diagnosis of cerebral vasospam, transcranial doppler is commonly the first-screening method for the detection of
cerebral vasospam. The treatment of subarachnoid haemorrhage -induced vasospasm include the use of both medical and
endovascular therapy. The aim of this review is to discuss the various current therapeutic options and future perspective
measures for reducing cerebral vasospasm induced stroke after SAH.
