Cerebral vasospasm following subarachnoid hemorrhage: time for a new world of thought.
OBJECTIVE
Delayed cerebral vasospasm has long been recognized as an important cause of poor outcome after an otherwise successful treatment of a ruptured intracranial aneurysm, but it remains a pathophysiological enigma despite intensive research for more than half a century.


METHODS
Summarized in this review are highlights of research from North America, Europe and Asia reflecting recent advances in the understanding of delayed ischemic deficit.


RESULTS
It will focus on current accepted mechanisms and on new frontiers in vasospasm research.


CONCLUSIONS
A key issue is the recognition of events other than arterial narrowing such as early brain injury and cortical spreading depression and of their contribution to overall mortality and morbidity.
Pluta
Ryszard M
RM
Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
Hansen-Schwartz
Jacob
J
Dreier
Jens
J
Vajkoczy
Peter
P
Macdonald
R Loch
RL
Nishizawa
Shigeru
S
Kasuya
Hideotoshi
H
Wellman
George
G
Keller
Emanuela
E
Zauner
Alois
A
Dorsch
Nicholas
N
Clark
Joseph
J
Ono
Shigeki
S
Kiris
Talat
T
Leroux
Peter
P
Zhang
John H
JH
D000818:Animals; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology; D013181:Cortical Spreading Depression / Q000502:physiology; D006801:Humans; D007391:International Cooperation; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D014661:Vasoconstriction / Q000502:physiology; D020301:Vasospasm, Intracranial / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality / Q000473:pathology