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Vasospasm
Karen L. Salzman, MD; Perry P. Ng, MBBS (Hons), FRANZCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • Subarachnoid hemorrhage (SAH) vasospasm
          • Definitions

            • Exposure to blood breakdown products → reversible stenosis of intracranial arteries
              • Contraction of vascular smooth muscle
              • Histological changes in vessel wall

          IMAGING

          • General Features

            • Imaging Recommendations

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Bacigaluppi S et al: Diagnosis of cerebral vasospasm and risk of delayed cerebral ischemia related to aneurysmal subarachnoid haemorrhage: an overview of available tools. Neurosurg Rev. ePub, 2015
                                          2. Fontana J et al: Dynamic Autoregulatory Response After Aneurysmal Subarachnoid Hemorrhage and Its Relation to Angiographic Vasospasm and Clinical Outcome. Neurocrit Care. ePub, 2015
                                          3. Hollingworth M et al: Results of an International Survey on the Investigation and Endovascular Management of Cerebral Vasospasm and Delayed Cerebral Ischemia. World Neurosurg. ePub, 2015
                                          4. Walcott BP et al: Diffuse patterns of nonaneurysmal subarachnoid hemorrhage originating from the Basal cisterns have predictable vasospasm rates similar to aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 24(4):795-801, 2015
                                          5. Jones J et al: Cerebral vasospasm patterns following aneurysmal subarachnoid hemorrhage: an angiographic study comparing coils with clips. J Neurointerv Surg. ePub, 2014
                                          6. Eddleman CS et al: Endovascular options in the treatment of delayed ischemic neurological deficits due to cerebral vasospasm. Neurosurg Focus. 26(3):E6, 2009
                                          7. Hänggi D et al: Feasibility and safety of intrathecal nimodipine on posthaemorrhagic cerebral vasospasm refractory to medical and endovascular therapy. Clin Neurol Neurosurg. 110(8):784-90, 2008
                                          8. Ionita CC et al: The value of CT angiography and transcranial doppler sonography in triaging suspected cerebral vasospasm in SAH prior to endovascular therapy. Neurocrit Care. 9(1):8-12, 2008
                                          9. Keuskamp J et al: High-dose intraarterial verapamil in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 108(3):458-63, 2008
                                          10. Majoie CB et al: Perfusion CT to evaluate the effect of transluminal angioplasty on cerebral perfusion in the treatment of vasospasm after subarachnoid hemorrhage. Neurocrit Care. 6(1):40-4, 2007
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Subarachnoid hemorrhage (SAH) vasospasm
                                                  • Definitions

                                                    • Exposure to blood breakdown products → reversible stenosis of intracranial arteries
                                                      • Contraction of vascular smooth muscle
                                                      • Histological changes in vessel wall

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Angiographic Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Bacigaluppi S et al: Diagnosis of cerebral vasospasm and risk of delayed cerebral ischemia related to aneurysmal subarachnoid haemorrhage: an overview of available tools. Neurosurg Rev. ePub, 2015
                                                                                  2. Fontana J et al: Dynamic Autoregulatory Response After Aneurysmal Subarachnoid Hemorrhage and Its Relation to Angiographic Vasospasm and Clinical Outcome. Neurocrit Care. ePub, 2015
                                                                                  3. Hollingworth M et al: Results of an International Survey on the Investigation and Endovascular Management of Cerebral Vasospasm and Delayed Cerebral Ischemia. World Neurosurg. ePub, 2015
                                                                                  4. Walcott BP et al: Diffuse patterns of nonaneurysmal subarachnoid hemorrhage originating from the Basal cisterns have predictable vasospasm rates similar to aneurysmal subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 24(4):795-801, 2015
                                                                                  5. Jones J et al: Cerebral vasospasm patterns following aneurysmal subarachnoid hemorrhage: an angiographic study comparing coils with clips. J Neurointerv Surg. ePub, 2014
                                                                                  6. Eddleman CS et al: Endovascular options in the treatment of delayed ischemic neurological deficits due to cerebral vasospasm. Neurosurg Focus. 26(3):E6, 2009
                                                                                  7. Hänggi D et al: Feasibility and safety of intrathecal nimodipine on posthaemorrhagic cerebral vasospasm refractory to medical and endovascular therapy. Clin Neurol Neurosurg. 110(8):784-90, 2008
                                                                                  8. Ionita CC et al: The value of CT angiography and transcranial doppler sonography in triaging suspected cerebral vasospasm in SAH prior to endovascular therapy. Neurocrit Care. 9(1):8-12, 2008
                                                                                  9. Keuskamp J et al: High-dose intraarterial verapamil in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 108(3):458-63, 2008
                                                                                  10. Majoie CB et al: Perfusion CT to evaluate the effect of transluminal angioplasty on cerebral perfusion in the treatment of vasospasm after subarachnoid hemorrhage. Neurocrit Care. 6(1):40-4, 2007