Endovascular options in the treatment of delayed ischemic neurological deficits due to cerebral vasospasm

Christopher S. Eddleman, Michael C. Hurley, Andrew M. Naidech, H. Hunt Batjer, Bernard R. Bendok

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

The second leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage (SAH) is delayed cerebral ischemia due to vasospasm. Although up to 70% of patients have been shown to have angiographic evidence of vasospasm, only 20-30% will present with clinical changes, including mental status changes and neurological deficits that necessitate acute management. Endovascular capabilities have progressed to become viable options in the treatment of cerebral vasospasm. The rationale for intraarterial therapy includes the fact that morbidity and mortality rates have not changed in recent years despite optimized noninvasive medical care. In this report, the authors discuss the most common endovascular options-namely intraarterial vasodilators and transluminal balloon angioplasty-from the standpoint of mechanism, efficacy, limitations, and complications as well as the treatment algorithms for cerebral vasospasm used at our institution.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalNeurosurgical focus
Volume26
Issue number3
DOIs
StatePublished - Oct 13 2009

Keywords

  • Calcium antagonist
  • Delayed ischemic neurological deficit
  • Endovascular procedure
  • Intraarterial vasodilator
  • Subarachnoid hemorrhage
  • Transluminal balloon angioplasty
  • Vasospasm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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