title: Vasospasm in aneurysmal subarachnoid hemorrhage: diagnosis, prevention, and management.
abstract: Cerebral vasospasm is a major cause of morbidity and mortality associated with subarachnoid hemorrhage (SAH). Advances in neuroimaging and development of newer intraparenchymal monitoring devices have improved the prediction and diagnosis of cerebral vasospasm significantly. Recent experimental and clinical trials have increased the armamentarium of preventive and treatment strategies for cerebral vasospasm. Vasospasm refractory to medical therapy usually is treated endovascularly with percutaneous transluminal balloon angioplasty (PTA) for proximal vessel vasospasm and vasodilator infusion for distal vessel vasospasm. Although vasospasm usually does not recur after PTA, recurrence is frequent after vasodilator infusion. The development of newer microballoon catheters has led to improvements in treatment of not only proximal but also distal vessel vasospasm with balloon angioplasty. This article reports on current knowledge in the diagnosis, prediction, prevention, and management of cerebral vasospasm.
authors.affiliation: New York-Presbyterian Hospital, Weill-Cornell Medical College of Cornell University, 525 E 68th Street, P.O. Box 141, New York, NY 10021, USA. drvallabh@yahoo.com
authors.forename: Vallabh
authors.initials: V
authors.lastname: Janardhan
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biondi
authors.forename: Howard A
authors.initials: HA
authors.lastname: Riina
authors.forename: Pina C
authors.initials: PC
authors.lastname: Sanelli
authors.forename: Philip E
authors.initials: PE
authors.lastname: Stieg
authors.forename: Y Pierre
authors.initials: YP
authors.lastname: Gobin
mesh_terms: D006801:Humans; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D020301:Vasospasm, Intracranial / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*