Neuroradiologic diagnosis and treatment of vasospasm.
For survivors of aneurysmal subarachnoid hemorrhage, cerebral vasospasm significantly contributes to its morbidity and mortality by causing delayed ischemic neurological deficit. Noninvasive evaluation with computed tomography, transcranial doppler and single photon emission computerized tomography helps guide clinical decisions. Endovascular therapy of symptomatic vasospasm with balloon angioplasty and to a lesser extent with intraarterial papaverine infusion has emerged as an important treatment adjunct to neurosurgical medical and operative management. Early and aggressive treatment with balloon angioplasty has resulted in sustained clinical improvement in about two-thirds of patients suffering from neurological deficits attributable to vasospasm. Encouraging long-term clinical and transcranial artery damage following angioplasty. Despite balloon angioplasty's 2% to 5% peri-procedure mortality rate, it remains under used.
Song
J K
JK
Department of Radiology, University of Washington, Seattle, Washington 98195, USA.
Elliott
J P
JP
Eskridge
J M
JM
D000800:Angioplasty, Balloon; D002545:Brain Ischemia / Q000209:etiology; D003131:Combined Modality Therapy; D003657:Decision Making; D006801:Humans; D007269:Injections, Intra-Arterial; D002532:Intracranial Aneurysm / Q000150:complications; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery / Q000628:therapy; D008137:Longitudinal Studies; D009485:Neuroradiography; D010208:Papaverine / Q000008:administration & dosage / Q000627:therapeutic use; D013345:Subarachnoid Hemorrhage / Q000150:complications; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use
D014665:Vasodilator Agents; D010208:Papaverine