Chemical angioplasty with spasmolytics for vasospasm after subarachnoid hemorrhage

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F17%3A00066941" target="_blank" >RIV/00159816:_____/17:00066941 - isvavai.cz</a>

Alternative codes found

RIV/44555601:13440/17:43888410 RIV/44555601:13450/17:43893449 RIV/00216208:11110/17:10362250 RIV/00216208:11140/17:10362250 and 2 more

Result on the web

<a href="http://dx.doi.org/10.1007/s00701-017-3104-5" target="_blank" >http://dx.doi.org/10.1007/s00701-017-3104-5</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00701-017-3104-5" target="_blank" >10.1007/s00701-017-3104-5</a>

Result language

angličtina

Original language name

Chemical angioplasty with spasmolytics for vasospasm after subarachnoid hemorrhage

Original language description

Background Clinically symptomatic vasospasm leading to delayed ischemic neurological deficits occurs in up to 30% of patients with subarachnoid hemorrhage (SAH). Vasospasm can result in a serious decline in clinical conditions of patients with SAH, yet the algorithm for vasospasm treatment and prevention remains unclear. Intra-arterial administration of vasodilators is one of the modalities used for vasospasm therapy. Methods Over the last 7 years, we have treated 27 female and 7 male patients with vasospasm using intra-arterial administration of either nimodipine or milrinone; all had suffered aneurysm rupture. Of these patients, 28 were treated surgically (clip), and 6 patients had their aneurysm coiled. Spasmolytics were applied from day 2 to day 18 after rupture. Results Of the 53 procedures, angiographic improvement was documented in 92% of cases with a mean flow velocity decrease of 65 cm/s. Brain metabolism changes were monitored after the procedure. The highest level of immediate clinical improvement was observed in conscious patients with a focal neurological deficit (aphasia, hemiparesis). Overall clinical outcomes (Glasgow outcome scale, GOS) were as follows: GOS 5 (12 patients), GOS 4 (5 patients), GOS 3 (5 patients), GOS 2 (6 patients), and GOS 1 (6 patients). Conclusions Intra-arterial administration of spasmolytics is a safe and potent method of vasospasm treatment. It is most effective when applied to conscious patients with a focal deficit. For unconscious patients, its therapeutic benefits are inconclusive. Patients in severe clinical states would further require use of other diagnostic tools such as multimodal brain monitoring to complement vasospasm therapy.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

Result was created during the realization of more than one project. More information in the Projects tab.

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Acta Neurochirurgica

ISSN

0001-6268

e-ISSN

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Volume of the periodical

159

Issue of the periodical within the volume

4

Country of publishing house

AT - AUSTRIA

Number of pages

8

Pages from-to

713-720

UT code for WoS article

000398164500018

EID of the result in the Scopus database

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