Cerebral vasospasm after subarachnoid hemorrhage: An update

Roberto Heros, N. T. Zervas, V. Varsos

Research output: Contribution to journalArticle

256 Citations (Scopus)

Abstract

Symptomatic vasospasm, or delayed cerebral ischemia associated with arteriographic evidence of arterial constriction, is currently the most important cause of morbidity after acute subarachnoid hemorrhage. The development of vasospasm is directly correlated with the presence of thick blood clots in the basal subarachnoid cisterns, which can be detected by an early computed tomographic scan. Symptomatic vasospasm usually develops between 4 and 12 days after subarachnoid hemorrhage. The onset is gradual, occurring over hours or days. There is typically a gradual deterioration of the level of consciousness, accompanied by focal neurological deficits that are determined by the arterial territories involved. Hyponatremia frequently occurs and may exacerbate the symptoms. The patients are usually volume depleted, and therefore many authorities now treat them with replenishment and expansion of their intravascular volume with colloid and blood. Volume expansion, together with elevation of the systemic blood pressure and reduction of the intracranial pressure when elevated, constitute the only currently available effective therapy for symptomatic vasospasm. The cause of vasospasm remains obscure. Mechanisms of smooth muscle cell contraction and relaxation and experimental efforts to elucidate the nature of vasospasm are reviewed.

Original languageEnglish
Pages (from-to)599-608
Number of pages10
JournalAnnals of Neurology
Volume14
Issue number6
StatePublished - Dec 1 1983
Externally publishedYes

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Intracranial Vasospasm
Subarachnoid Hemorrhage
Muscle Relaxation
Intracranial Hypertension
Hyponatremia
Colloids
Muscle Contraction
Brain Ischemia
Consciousness
Constriction
Smooth Muscle Myocytes
Thrombosis
Blood Pressure
Morbidity
Therapeutics

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Heros, R., Zervas, N. T., & Varsos, V. (1983). Cerebral vasospasm after subarachnoid hemorrhage: An update. Annals of Neurology, 14(6), 599-608.

Cerebral vasospasm after subarachnoid hemorrhage : An update. / Heros, Roberto; Zervas, N. T.; Varsos, V.

In: Annals of Neurology, Vol. 14, No. 6, 01.12.1983, p. 599-608.

Research output: Contribution to journalArticle

Heros, R, Zervas, NT & Varsos, V 1983, 'Cerebral vasospasm after subarachnoid hemorrhage: An update', Annals of Neurology, vol. 14, no. 6, pp. 599-608.
Heros, Roberto ; Zervas, N. T. ; Varsos, V. / Cerebral vasospasm after subarachnoid hemorrhage : An update. In: Annals of Neurology. 1983 ; Vol. 14, No. 6. pp. 599-608.
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