Advances in vasospasm treatment and prevention.
Outcome after aSAH depends on several factors, including the severity of the initial event, perioperative medical management, surgical variables, and the incidence of complications. Cerebral vasospasm (CV) is ure to consistently respond to treatment, emphasizing the need for further research into the underlying mechanisms of SAH-induced cerebrovascular dysfunction. To this end, our paper reviews the relevant literature on the main therapies employed for CV after aSAH and discusses possible avenues for future investigations. Current management of this condition consists of maximal medical therapy, including triple H regimen and oral administration of calcium antagonists, followed by endovascular balloon angioplasty and/or injection of vasodilatory agents for refractory cases. As the precise pathophysiology of CV is further elucidated, the development of promising investigational therapies will follow.
Komotar
Ricardo J
RJ
Department of Neurosurgery, Columbia University, New York, NY, USA.
Zacharia
Brad E
BE
Valhora
Ricky
R
Mocco
J
J
Connolly
E Sander
ES
D000800:Angioplasty, Balloon; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D009569:Nitric Oxide / Q000627:therapeutic use; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000517:prevention & control* / Q000628:therapy; D014665:Vasodilator Agents / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000188:drug therapy* / Q000517:prevention & control* / Q000628:therapy
D000893:Anti-Inflammatory Agents; D002121:Calcium Channel Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014665:Vasodilator Agents; D009569:Nitric Oxide