New Modalities in Management of Cerebral artery Spasm Due to Spontaneous Subarachnoid Hemorrhage

Abstract

pontaneous subarachnoid hemorrhage is a bleeding into the subarachnoid space without trauma. Aneurysms are the underlying cause in 80% of the cases. Among other causes are arteriovenous malformations, anticoagulation, vasculitis and brain tumor. Spontaneous subarachnoid hemorrhage is a serious disease where up to half of the patients die. Of those who survive, only half return to work and many have a reduced quality of life. Aneurysmal subarachnoid hemorrhage (aSAH) constitutes a major cause of stroke, as approximately 3–15% of all stroke cases are due to ruptured intracranial aneurysms Outcome after aSAH depends on several factors, including the severity of the initial event, therapeutical medical management, various surgical variables, and the incidence of aSAH induced complications. Cerebral vasospasm (CV) is the most frequent and troublesome complication after aSAH. Cerebral vasospasm is a condition of morphologic narrowing of cerebral arteries that is most commonly seen following aneurysmal subarachnoid haemorrhage (aSAH), but may also follow other intracranial hemorrhages, like intraventricular haemorrhage from arteriovenous malformations (AVM), SAH of unknown etiology, traumatic brain injury with or without SAH, brain surgery and may be associated with