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Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage and Traumatic Brain Injury

  • Saef Izzy
  • Susanne MuehlschlegelEmail author
CRITICAL CARE NEUROLOGY (KN SHETH, SECTION EDITOR)
Part of the following topical collections:
  1. Topical Collection on Critical Care Neurology

Opinion statement

Cerebral vasospasm (cVSP) consists of the vasoconstriction of large and small intracranial vessels which can lead to cerebral hypoperfusion, and in extreme cases, delayed ischemic deficits with stroke. While most commonly observed after aneurysmal subarachnoid hemorrhage (aSAH), cVSP can also occur after traumatic brain injury (TBI) as we have described in detail in this review. For the past decades, the research attention has focused on cVSP because of its association with delayed cerebral ischemia, which is the largest contributor of morbidity and mortality after aSAH. New discoveries in the cVSP pathophysiology involving multifactorial complex cascades and pathways pose new targets for therapeutic interventions in the prevention and treatment of cVSP. The goal of this review is to demonstrate the commonalities and differences in epidemiology and pathophysiology of both aSAH and TBI-associated cVSP, and highlight the more recently discovered pathways of cVSP. Finally, the latest cVSP surveillance methods and treatment options are illustrated.

Keywords

Cerebral vasospasm Angiographic vasospasm Delayed cerebral ischemia Traumatic brain injury Subarachnoid hemorrhage Traumatic subarachnoid hemorrhage Blast injury Treatment Aneurysmal subarachnoid hemorrhage 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Susanne Muehlschlegel has received grant support from the American Heart Association.

Saef Izzy declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the authors’ research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Neurology (Neurocritical Care)University of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Department of SurgeryUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Department of Anesthesiology/Critical CareUniversity of Massachusetts Medical SchoolWorcesterUSA

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