Simultaneous head rotation and lumboventricular lavage in patients after severe subarachnoid haemorrhage: an initial analysis of the influence on clot clearance rate and cerebral vasospasm

The Influence of Cisternal and Ventricular Lavage on Cerebral Vasospasm in Patients Suffering from Subarachnoid Hemorrhage: Analysis of Effectiveness

“…The study demonstrated that a combination of cisternal lavage and head-shaking revealed a decrease of cerebral vasospasm and an increase of patients outcome [16]. Same positive results were documented for the use of neutral lavage in combination with the lateral rotational therapy [10,11]. Complications such as motion sickness, brain swelling and even hemorrhage were reported in patients treated with the Neuroshaker [2].…”

“…The first multimodal approaches using a combination of intracisternal thrombolysis or neutral lavage in combination with kinetic therapy demonstrated in all clinical trials a 2009 [9] Prospective 20 tPA, nimodipine and lateral rotational therapy Randomized moderate effectiveness on cerebral vasospasm and outcome of patients after aneurysmal SAH [9][10][11]16]. Additionally an increased clot clearance rate was documented in at least one study [10].…”

“…Complications such as motion sickness, brain swelling and even hemorrhage were reported in patients treated with the Neuroshaker [2]. For the chosen lateral rotational therapy there was no associated complication of the RotoRest 1 therapy [10,11].…”

“…Additional the local treatment could be performed by intracisternal prolonged release implants [4,15] or intracisternal thrombolysis with or without the use of the kinetic therapy [1,10,11,16]. The current analysis was performed to review the efficacy of cisternal and ventricular lavage with or without the combination of kinetic therapy in patients suffering from severe aneurysmal SAH.…”

A Multimodal Concept in Patients after Severe Aneurysmal Subarachnoid Hemorrhage: Results of a Controlled Single Centre Prospective Randomized Multimodal Phase I/II Trial on Cerebral Vasospasm

“…First, a meta-analysis of the eff ect of intracisternal thrombolysis based on the evaluation of a total of nine clinical trials has suggested a clinically relevant and statistically signifi cant benefi cial eff ect [1] . Other reports have demonstrated that the benefi t of clot lysis could be augmented by applying a combination of intracisternal lavage and some sort of kinetic therapy [14, 15,21] . Finally, recent studies focusing on intracisternal prolonged release of the calcium channel antagonist nicardipine via pellets reported promising initial results [5,20] .…”