Persistent intracranial hypertension treated by hypothermic therapy after severe head injury might induce late-phase cerebral vasospasm.
BACKGROUND
Vasospasm caused by intracranial hypertension in head injury remains controversial.


METHODS
Between 1996 and 2004, we prospectively and consecutively performed conventional cerebral angiography for six patients with head injuries who showed persistent intracranial hypertension (over 20 mm Hg for longer than 5 days) despite performing various treatments for intracranial hypertension.


RESULTS
All subjects had a minor hemorrhage at admission, classified as Fisher group 2. Five of the six patients had angiographically confirmed vasospasm, and one of them later developed a cerebral infarction. Four of the five subjects who exhibited cerebral vasospasm had undergone hypothermic therapy to control the intracranial hypertension.


CONCLUSIONS
Our results suggest that persistent intracranial hypertension that is treated by hypothermic therapy may be related to late phase cerebral vasospasm.
Yanagawa
Youichi
Y
Department of Traumatology and Critical Care Medicine, National Defense Medical College, Saitama, Japan. yangawa@me.ndmc.ac.jp
Sakamoto
Toshihisa
T
Okada
Yoshiaki
Y
D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D006259:Craniocerebral Trauma / Q000150:complications; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D019586:Intracranial Hypertension / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000209:etiology*