A review of current and future medical therapies for cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
In an effort to help clarify the current state of medical therapy for cerebral vasospasm, the authors reviewed the relevant literature on the established medical therapies used for cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH), and they discuss burgeoning areas of investigation. Despite advances in the treatment of aneurysmal SAH, cerebral vasospasm remains a common complication and has been correlated with a 1.5- to threefold increase in death during the first 2 weeks after hemorrhage. A number of medical, pharmacological, and surgical therapies are currently in use or being investigated in an attempt to reverse cerebral vasospasm, but only a few have proven to be useful. Although much has been elucidated regarding its pathophysiology, the treatment of cerebral vasospasm remains a dilemma. Although a poor understanding of SAH-induced cerebral vasospasm pathophysiology has, to date, hampered the development of therapeutic interventions, current research efforts promise the eventual production of new medical therapies.
Mocco
J
J
Department of Neurosurgery, Columbia University, New York, New York 10032, USA.
Zacharia
Brad E
BE
Komotar
Ricardo J
RJ
Connolly
E Sander
ES
D000596:Amino Acids / Q000627:therapeutic use; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008274:Magnesium / Q000627:therapeutic use; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013997:Time Factors; D020301:Vasospasm, Intracranial / Q000209:etiology* / Q000628:therapy*
D000596:Amino Acids; D000893:Anti-Inflammatory Agents; D002121:Calcium Channel Blockers; D004791:Enzyme Inhibitors; D008274:Magnesium; C013165:statine