Effect of intraarterial verapamil on the diameter of vasospastic intracranial arteries in patients with cerebral vasospasm

Avi Mazumdar, Dennis J. Rivet, Colin P. Derdeyn, DeWitte T. Cross, Christopher J. Moran
2006 Neurosurgical Focus  
EREBRAL vasospasm is a major complication of aneurysmal SAH. Its effects peak from 4 to 12 days after the initial rupture, and it results in a marked increase in morbidity and mortality. Cerebral vasospasm that can be confirmed using angiography occurs to some degree in up to 70% of all patients with aneurysmal SAH, with approximately 14 to 40% of them developing clinical vasospasm. Some researchers have hypothesized that some microcirculatory vasospasm of penetrating vessels is smaller than
more » ... is smaller than can be shown by the highest resolution of angiography, which may explain changes in the mental status of patients with normal results on angiograms. Five to 20% of patients admitted for aneurysmal SAH die as a result of vasospasm. Vasospasm occurs primarily, but not exclusively, in large proximal vessels near the basilar cisterns and is related to the amount of blood surrounding the proximal cerebral vasculature, which was quantified by both the Fisher and Columbia scales for grading of SAH on CT scans. 8, 10, 13, 18 Having hypertension, smoking, using cocaine, and being Abbreviations used in this paper: CT = computed tomography; ICA = internal carotid artery; ICP = intracranial pressure; SAH = subarachnoid hemorrhage. C
doi:10.3171/foc.2006.21.3.15 pmid:17029339 fatcat:zjg4lrn6rzdbfghzqr53zcecgu