Endovascular treatment of vasospasm related to acute subarachnoid hemorrhage from ruptured aneurysms.
Citation: Acta Neurochirurgica - Supplement. 120:223-9, 2015.PMID: 25366628Institution: MedStar Washington Hospital CenterDepartment: RadiologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Angioplasty, Balloon/mt [Methods] | *Embolization, Therapeutic/mt [Methods] | *Subarachnoid Hemorrhage/th [Therapy] | *Vasospasm, Intracranial/th [Therapy] | Acute Disease | Adult | Aneurysm, Ruptured/co [Complications] | Aneurysm, Ruptured/ra [Radiography] | Aneurysm, Ruptured/th [Therapy] | Cerebral Angiography | Cerebrovascular Circulation | Female | Humans | Male | Middle Aged | Retrospective Studies | Subarachnoid Hemorrhage/co [Complications] | Subarachnoid Hemorrhage/ra [Radiography] | Treatment Outcome | Vasospasm, Intracranial/et [Etiology] | Vasospasm, Intracranial/ra [Radiography]ISSN:- 0065-1419
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Journal Article | MedStar Authors Catalog | Article | Available | 25366628 |
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.
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