Prevention of vasospasm by early operation with removal of subarachnoid blood

Mizukami, M; Kawase, T; Usami, T; Tazawa, T

doi:10.1097/00006123-198203000-00001

Cited by 20 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 22 We were not able to confirm that thick clot (Fisher grade 3) 23 or intraventricular haemorrhage increased the risk of cerebral infarction, 24 although the amount of subarachnoid blood 25 and worse neurological grade did increase the risk. 18 This may reflect a benefit from the ability to wash out subarachnoid blood at surgery, 26 the predominant mode of treatment at our institution. Thick clot and ventricular haemorrhage may predict cerebral infarction during the vasospasm period but not early cerebral infarction.…”

Section: Discussionmentioning

confidence: 99%

Acute physiological derangement is associated with early radiographic cerebral infarction after subarachnoid haemorrhage

Naidech

Drescher

Tamul

et al. 2006

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

Background: Cerebral infarction after aneurysmal subarachnoid haemorrhage (SAH) is presumed to be due to cerebral vasospasm, defined as arterial lumen narrowing from days 3 to 14. Methods: We reviewed the computed tomography scans of 103 patients with aneurysmal SAH for radiographic cerebral infarction and controlled for other predictors of outcome. A blinded neuroradiologist reviewed the angiograms. Cerebral infarction from vasospasm was judged to be unlikely if it was visible on computed tomography within 2 calendar days of SAH or if angiography showed no vasospasm in a referable vessel, or both. Results: Cerebral infarction occurred in 29 (28%) of 103 patients with SAH. 18 patients had cerebral infarction that was unlikely to be due to vasospasm because it was visible on computed tomography by day 2 (6 (33%)) or because angiography showed no vasospasm in a referable artery (7 (39%)), or both (5 (28%)). In a multivariate model, cerebral infarction was significantly related to World Federation of Neurologic Surgeons grade (odds ratio (OR) 1.5/grade, 95% confidence interval (CI) 1.1 to 2.01, p = 0.006) and SAH-Physiologic Derangement Score (PDS) .2 (OR 3.7, 95% CI 1.4 to 9.8, p = 0.01) on admission. Global cerebral oedema (OR 4.3, 95% CI 1.5 to 12.5, p = 0.007) predicted cerebral infarction. Patients with cerebral infarction detectable by day 2 had a higher SAH-PDS than patients with later cerebral infarction (p = 0.025). Conclusions : Many cerebral infarctions after SAH are unlikely to be caused by vasospasm because they occur too soon after SAH or because angiography shows no vasospasm in a referable artery, or both. Physiological derangement and cerebral oedema may be worthwhile targets for intervention to decrease the occurrence and clinical impact of cerebral infarction after SAH.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute physiological derangement is associated with early radiographic cerebral infarction after subarachnoid haemorrhage

Naidech

Drescher

Tamul

et al. 2006

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

show abstract

“…53,76 There has been some suggestion that early clot removal may reduce the risk of developing subsequent vasospasm, 34,45,58,84,90 although this effect has not been substantiated. 37,53,82,94 Nevertheless, it is generally agreed that an aneurysm that has been secured (clipped or coiled) facilitates the safe treatment of vasospasm.…”

Section: Discussionmentioning

confidence: 99%

Ultra-early surgery for aneurysmal subarachnoid hemorrhage: outcomes for a consecutive series of 391 patients not selected by grade or age

Laidlaw

Siu²

2002

Journal of Neurosurgery

125

View full text Add to dashboard Cite

show abstract

“…Subarachnoid hematoma evacuation during aneurysm clipping was initially thought to reduce the incidence of vasospasm 9 10. However, further studies have not shown a consistent advantage of surgery over endovascular coiling in this respect.…”

Section: Introductionmentioning

confidence: 99%

Cerebral vasospasm patterns following aneurysmal subarachnoid hemorrhage: an angiographic study comparing coils with clips

Jones

Sayre

Chang

et al. 2014

J NeuroIntervent Surg

View full text Add to dashboard Cite

show abstract

Prevention of vasospasm by early operation with removal of subarachnoid blood

Cited by 20 publications

References 0 publications

Acute physiological derangement is associated with early radiographic cerebral infarction after subarachnoid haemorrhage

Acute physiological derangement is associated with early radiographic cerebral infarction after subarachnoid haemorrhage

Ultra-early surgery for aneurysmal subarachnoid hemorrhage: outcomes for a consecutive series of 391 patients not selected by grade or age

Cerebral vasospasm patterns following aneurysmal subarachnoid hemorrhage: an angiographic study comparing coils with clips

Contact Info

Product

Resources

About