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Cerebral Vasospasm
Cerebral vasospasm is narrowing (spasm) of blood vessels in the brain.
Vasospasm of the vessels that supply the brain can occur after a bleed from
an aneurysm in the head, and is the most significant complication of this
kind of bleed (subarachnoid hemorrhage). The spasm can be severe enough to
prevent enough blood from reaching the brain, causing a stroke. Cells in
that area of the brain die, and the part of the body they control cannot
function. The earlier that medical intervention is started after the onset
of symptoms, the greater the probability of limiting or reversing brain
damage.
How is vasospasm treated?
Of patients that survive the bleed from the aneurysm, 5% to 20% die from
vasospasm, or suffer severe, often disabling deficits (such as paralysis).
The use of drugs to help prevent vasospasm has decreased this number in
recent years. Once vasospasm does occur (usually 4 to 12 days after a bleed
around the brain), there are several treatments that may be used to open the
vessels back up and prevent damage to the brain. These may include medical
therapy to increase the blood pressure and improve blood flow to the brain,
placement of a catheter in the arteries going to the brain in order to allow
injection of a drug directly into the arteries to dilate (open) them, or
putting a catheter with a balloon on it into the vessels and stretching them
open (angioplasty).
The procedure or procedures that are used depend on how severe the spasm is
and where in the blood vessels it occurs. Endovascular treatment for
vasospasm is just one of the therapies in the neurosurgeon’s armamentarium
to combat vasospasm should it occur. Sometimes, vasospasm will recur and
need to be treated multiple times. The potential complications and risks of
the procedure should be discussed with your doctor.
For more information go to: www.asitn.org
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