Skip to main content

Endovascular Treatment of Vasospasm Related to Acute Subarachnoid Hemorrhage from Ruptured Aneurysms

  • Chapter
  • First Online:
Neurovascular Events After Subarachnoid Hemorrhage


In the first 2 weeks after subarachnoid hemorrhage caused by a ruptured aneurysm, 30–35 % of surviving patients treated with conservative nonoperative therapy experience rebleeding. This is fatal in 60–90 % of cases and leads to significant disability in 17–20 % of cases. A major factor for this poor outcome is thought to be the vasospasm that occurs in up to 38.7 % by the third day, 46.3 % by the ninth day, and eventually in up to 70 % of patients. Endovascular treatment of aneurysms associated with acute subarachnoid hemorrhage has the potential to decrease the occurrence of rebleeding and therefore decrease the high mortality and morbidity associated with this disease. Treatment of vasospasm, if it does occur, has the potential to further improve patient outcomes. We describe the outcomes of 174 of our patients with acute subarachnoid hemorrhage caused by a ruptured aneurysm who were treated with endovascular techniques. Overall, the majority of our patients experienced a good or excellent outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others


  1. Feigin V, Rinkel J, Lawes C, Algra A, Bennett D, Gijn J, Anderson C (2005) Risk factors for subarachnoid hemorrhage: an updated systematic review of epidemiological studies. Stroke 36:2773–2780

    Article  PubMed  Google Scholar 

  2. Keedy A (2006) An overview of intracranial aneurysms. Mcgill J Med 9:141–146

    PubMed  PubMed Central  Google Scholar 

  3. Paoletti C, Dematons C, Bellec C, Raggueneau J, PayendelaGaranderie D, Lo L, Lot G, George B, Cophignon J, Merland J (1999) Medical management of vasospasm and hemodynamic alterations in the neurosurgical ICU. In: Interverntioanal neuroradiology. WB Saunders, Philadelphia, pp 602–612

    Google Scholar 

  4. Kassell N, Helm G, Simmons N, Phillips C, Cail W (1992) Treatment of cerebral vasospasm with intra-arterial papaverine. J Neurosurg 77:848–852

    Article  PubMed  CAS  Google Scholar 

  5. Clouston J, Numaguchi Y, Zoarski G, Aldrich E, Simard J, Zitnay K (1995) Intraarterial papaverine infusion for cerebral vasospasm after subarachnoid hemorrhage. AJNR Am J Neuroradiol 16:27–36

    PubMed  CAS  Google Scholar 

  6. Zubkov Y, Nikiforov B, Shustin V (1984) Balloon catheter technique for dilatation of constricted cerebral arteries after aneurysmal SAH. Acta Neurochir (Wien) 70:65–79

    Article  CAS  Google Scholar 

  7. Higashida R, Halbach V, Cahan L, Brant-Zawadzki M, Barnwell S, Dowd C, Hieshima G (1989) Transluminal angioplasty for treatment of intracranial arterial vasospasm. J Neurosurg 71:648–653

    Article  PubMed  CAS  Google Scholar 

  8. Zakharov A, Krylov V (1992) The angiographic diagnosis of vascular vasospasm in ruptured cerebral aneurysms. Zh Vopr Neirokhir Im N N Burdenko 6:3–5

    PubMed  Google Scholar 

  9. Fisher C, Kistler J, Davis J (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6:1–9

    Article  PubMed  CAS  Google Scholar 

  10. Teasdale G, Drake C, Hunt W, Kassell N, Sano K, Pertuiset B, De Villiers J (1988) A universal subarachnoid hemorrhage scale; report of a committee of the World Federation of Neurosurgical Societies. J Neurol Neurosurg Psychiatry 5:1457

    Article  Google Scholar 

  11. Bonita R, Beaglehole R (1988) Modification of the Rankin Scale: Recovery of motor function after stroke. Stroke 19:1497–1500

    Article  PubMed  CAS  Google Scholar 

  12. Rankin J (1957) Cerebral vascular accidents in patients over the age of 60. Scott Med J 2:200–215

    PubMed  CAS  Google Scholar 

  13. Osborn A (1994) Diagnostic neuroradiology. CV Mosby, St Louis

    Google Scholar 

  14. Dandy W (1938) Intracranial aneurysm of the internal carotid artery: cured by operation. Ann Surg 107:654–659

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  15. Serbinenko F (1974) Balloon catheterization and occlusion of major cerebral vessels. J Neurosurg 41:125–145

    Article  PubMed  CAS  Google Scholar 

  16. Scheglov V (1995) Endosaccular detachable balloon catheter treatment of cerebral saccular aneurysms. In: Endovascular Interventional Neuroradiology, (Ed) Robert NN, Holtzman, Bennett, Stein, Meidi Winston. Springer Verlag, New York, Inc. pp 298–311

    Google Scholar 

  17. Hilal S (1988) Synthetic fiber coated platinum coils successfully used for the endovascular treatment of arteriovenous malformations, aneurysms, and direct arteriovenous fistulae of the central nervous system. AJNR Am J Neuroradiol 9:1030

    Google Scholar 

  18. Guglielmi G, Vinuela F, Dion J, Duckwiler G (1991) Electrothrombosis of saccular aneurysms via endovascular approach. Part 2: Preliminary clinical experience. J Neurosurg 75:8–14

    Article  PubMed  CAS  Google Scholar 

  19. Murayama Y, Nien Y, Duckwiler G, Gobin Y, Jahan R, Frazee J, Martin N, Vinuela F (2003) Guglielmi detachable coiled embolization of cerebral aneurysms: 11 years’ experience. J Neurosurg 98:959–966

    Article  PubMed  Google Scholar 

Download references


The authors acknowledge Maryna Maranova for her thorough and detailed assistance in collecting, reviewing, and analyzing the clinical data related to this manuscript.

Conflict of Interest Statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Dmitry V. Scheglov MD, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Scheglov, D.V., Polischuk, M.E., Scheglov, V.I., Mamonova, M.Y., Monsein, L.H. (2015). Endovascular Treatment of Vasospasm Related to Acute Subarachnoid Hemorrhage from Ruptured Aneurysms. In: Fandino, J., Marbacher, S., Fathi, AR., Muroi, C., Keller, E. (eds) Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 120. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04980-9

  • Online ISBN: 978-3-319-04981-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics