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Chemical angioplasty with spasmolytics for vasospasm after subarachnoid hemorrhage.

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61383082%3A_____%2F17%3A00000405" target="_blank" >RIV/61383082:_____/17:00000405 - isvavai.cz</a>

  • Alternative codes found

    RIV/00159816:_____/17:00066941 RIV/44555601:13440/17:43888410 RIV/44555601:13450/17:43893449 RIV/00216208:11110/17:10362250 and 2 more

  • Result on the web

    <a href="https://www.ncbi.nlm.nih.gov/pubmed/28224318" target="_blank" >https://www.ncbi.nlm.nih.gov/pubmed/28224318</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>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Chemical angioplasty with spasmolytics for vasospasm after subarachnoid hemorrhage.

  • Original language description

    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

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30103 - Neurosciences (including psychophysiology)

Result continuities

  • Project

    <a href="/en/project/NT13883" target="_blank" >NT13883: Correlation of parameters of multimodal monitoring in secondary brain trauma and its treatment in patients with brain injury and subarachnoid hemorrhage</a><br>

  • Continuities

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

Others

  • Publication year

    2017

  • Confidentiality

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

Data specific for result type

  • Name of the periodical

    Acta Neurochirurgica

  • ISSN

    0001-6268

  • e-ISSN

  • 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

    2-s2.0-85013483773