Incidence of Hydrocephalus and Increased Ventricular Fluid Pressure in Patients with Ruptured Supratentorial Aneurysms

Vapalahti, Matti; Nieminen, V.; Kari, Komang

doi:10.1007/978-3-642-66508-0_24

Cited by 14 publications

(4 citation statements)

References 7 publications

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“…Some autlaors correlate a vasospasm with the intracranial pressure level (Vapalahti et al 1976). The mean pressure values of our case material were slightly higher on the first measuring day in patients without a spasm than in patients with a spasm.…”

Section: Discussioncontrasting

confidence: 41%

“…1973). A drainage of the spinal fluid is particularly indicated since, after an SAH, the absorption of spinal fluid is often impeded by an adhesion or a blockage of the absorption pathways by corpuscular components of the blood (Galera and Greitz 1970, Kusske et al 1973, Sundb~irg and Ponten 1976, Vapalahti et al 1976. In most cases the absorption pathways became unobstructed within two weeks, and the pressure of the spinal fluid was reduced (Lundberg et al 1974, Sundb~irg andPonten 1976).…”

Section: Discussionmentioning

confidence: 99%

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Intracranial pressure and pressure volume relation in patients with subarachnoid haemorrhage (SAH)

et al. 1978

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The development of the intracranial pressure after a subarachnoid haemorrhage was evaluated in 21 patients. A statistically significant relation between the intracranial pressure and the neurological findings was found, whereas vasospasms did not influence the intracranial pressure. In patients in a clinically critical condition, rhythmic pressure waves of a frequency of 1/minute were repeatedly observed.

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Section: Discussioncontrasting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

Intracranial pressure and pressure volume relation in patients with subarachnoid haemorrhage (SAH)

et al. 1978

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“…A few investigators have studied the possible effect of vasospasm on ICP in man. ~x,~3, 39 In the present study, we monitored the intraventricular pressure (IVP) continuously in 52 patients with recent rupture of an intracranial saccular aneurysm. Our purpose was to investigate the dynamic pressure variations in relation to the clinical condition of the patients and to the development of cerebral vaso-spasm.…”

mentioning

confidence: 99%

Intracranial pressure changes following aneurysm rupture

Voldby¹,

Enevoldsen²

1982

Journal of Neurosurgery

114

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Intraventricular pressure (IVP) was measured continuously by the method of Lundberg for an average period of 8 days in 52 patients with recent rupture of an intracranial saccular aneurysm. The patients were graded as follows according to the system of Hunt and Hess: 13 patients were Grades I-II, 19 patients Grades II-III, and 20 patients Grades III-V. The degree of cerebral arterial spasm was measured on angiograms taken on admission and approximately 7 days later. Drainage of ventricular cerebrospinal fluid was performed intermittently when IVP exceeded 25 mm Hg. The results showed a close correlation between changes in clinical grade and in mean IVP. Drainage improved the condition in uncomplicated cases, but was less effective or ineffective when severe vasospasm or rebleeding occurred. Lowering the IVP by drainage did not appear to increase the risk of rebleeding. In contrast to patients with no or slight spasm, patients with severe spasm had a permanently elevated IVP, even before spasm was demonstrable angiographically. A mean IVP exceeding 25 mm Hg for the whole period of monitoring was associated with a poor prognosis. Finally, indications for continuous monitoring of IVP and ventricular drainage in aneurysm patients are suggested.

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“… 23 Some authors have suggested that increased ICP in the setting of vasospasm is caused by ischemia-related cerebral edema. 24 Moreover, an animal study by Farrar 25 demonstrated a positive correlation between ICP and vasospasm, such that increased ICP worsens chronic vasospasm. Another possibility is an immune reaction to the leads, which mediates the release of inflammatory and vasoactive mediators.…”

Section: Discussionmentioning

confidence: 99%

Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case

Rogowski

Miller

Saway

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND The Responsive Neurostimulation (RNS) system is an implantable device for patients with drug-resistant epilepsy who are not candidates for resection of a seizure focus. As a relatively new therapeutic, the full spectrum of adverse effects has yet to be determined. A literature review revealed no previous reports of cerebral vasospasm following RNS implantation. OBSERVATIONS A 35-year-old man developed severe angiographic and clinical vasospasm following bilateral mesial temporal lobe RNS implantation. He initially presented with concerns for status epilepticus 8 days after implantation. On hospital day 3, a decline in his clinical examination prompted imaging studies that revealed a left middle cerebral artery (MCA) stroke with angiographic evidence of severe vasospasm of the left internal carotid artery (ICA), MCA, anterior cerebral artery (ACA), and right ICA and ACA. Despite improvements in angiographic vasospasm after appropriate treatment, a thrombus developed in the posterior M2 branch, requiring mechanical thrombectomy. Ultimately, the patient was stabilized and discharged to a rehabilitation facility with residual cognitive and motor deficits. LESSONS Cerebral vasospasm as a cause of ischemic stroke after uneventful RNS implantation is exceedingly rare, yet demands particular attention given the potential for severe consequences and the growing number of patients receiving RNS devices.

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Incidence of Hydrocephalus and Increased Ventricular Fluid Pressure in Patients with Ruptured Supratentorial Aneurysms

Cited by 14 publications

References 7 publications

Intracranial pressure and pressure volume relation in patients with subarachnoid haemorrhage (SAH)

Intracranial pressure and pressure volume relation in patients with subarachnoid haemorrhage (SAH)

Intracranial pressure changes following aneurysm rupture

Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case

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