Clinical aspects of vasospasm.

F. G. Barker, Roberto Heros

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

In summary, clinically significant vasospasm is characterized by several relatively consistent features. Those patients most at risk are adults, of either sex, who have had a subarachnoid hemorrhage about 4 to 9 days previously; who had a poor clinical grade on admission; and in whom a CT scan taken 24 to 48 hours after the ictus showed a thick layer of blood surrounding one or more of the major cerebral vessels. Initially afebrile, affected patients later develop a steady low-grade fever and may have an elevated WBC count, but no infectious source of fever can be found. Patients complain of worsening headache, but not as bad as the one a few days ago; the neck may feel a little more stiff. The pulse is slightly faster than usual, the blood pressure perhaps a bit higher; however, the ECG shows only "cerebral T waves." An antifibrinolytic agent may have been used. The serum sodium concentration has dropped significantly. Such patients need a more thorough examination than usual, directed toward more subtle neurologic signs, and a few extra checks during the day by both physician and nurses, so that we can apply what remedies we have when the patients are just "a little more confused," rather than later, when they are exhibiting decerebrate posturing and coma.

Original languageEnglish
Pages (from-to)277-288
Number of pages12
JournalNeurosurgery Clinics of North America
Volume1
Issue number2
StatePublished - Apr 1 1990
Externally publishedYes

Fingerprint

Decerebrate State
Fever
Antifibrinolytic Agents
Subarachnoid Hemorrhage
Coma
Neurologic Manifestations
Headache
Pulse
Electrocardiography
Neck
Sodium
Nurses
Blood Pressure
Physicians
Serum

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Clinical aspects of vasospasm. / Barker, F. G.; Heros, Roberto.

In: Neurosurgery Clinics of North America, Vol. 1, No. 2, 01.04.1990, p. 277-288.

Research output: Contribution to journalArticle

Barker, F. G. ; Heros, Roberto. / Clinical aspects of vasospasm. In: Neurosurgery Clinics of North America. 1990 ; Vol. 1, No. 2. pp. 277-288.
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