Authors: Matthew M Kimball Gregory J Velat Brian L Hoh The Participants in the International Multidisciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage
Publish Date: 2011/07/15
Volume: 15, Issue: 2, Pages: 336-
Abstract
Cerebral vasospasm and delayed cerebral ischemia account for significant morbidity and mortality after aneurysmal subarachnoid hemorrhage While most patients are managed with tripleH therapy endovascular treatments have been used when tripleH treatment cannot be used or is ineffective An electronic literature search was conducted to identify English language articles published through October 2010 that addressed endovascular management of vasospasm A total of 49 articles were identified addressing endovascular treatment timing intraarterial treatments and balloon angioplasty Most of the available studies investigated intraarterial papaverine or balloon angioplasty Both have generally been shown to successfully treat vasospasm and improve neurological condition with no clear benefit from one treatment compared with another There are reports of complications with both therapies including vessel rupture during angioplasty intracranial hypertension and possible neurotoxicity associated with papaverine Limited data are available evaluating nicardipine or verapamil with positive benefits reported with nicardipine and inconsistent benefits with verapamilThe Participants in the International Multidisciplinary Consensus Conference Michael N Diringer Thomas P Bleck Nicolas Bruder E Sander Connolly Jr Giuseppe Citerio Daryl Gress Daniel Hanggi J Claude Hemphill III MAS Brian Hoh Giuseppe Lanzino Peter Le Roux David Menon Alejandro Rabinstein Erich Schmutzhard Lori Shutter Nino Stocchetti Jose Suarez Miriam Treggiari MY Tseng Mervyn Vergouwen Paul Vespa Stephan Wolf Gregory J Zipfel
Keywords: