Vasospasm and delayed cerebral ischemia after subarachnoid hemorrhage

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  • Sakuraya Masaaki
    Department of Emergency and Intensive Care Medicine, JA Hiroshima General Hospital

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Other Title
  • くも膜下出血後の脳血管攣縮と遅発性脳虚血
Published
2021-11-01
DOI
  • 10.3918/jsicm.28_509
Publisher
The Japanese Society of Intensive Care Medicine

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<p>Although subarachnoid hemorrhage (SAH) due to ruptured aneurysm occurs less frequently than other forms of stroke, it is more likely to occur in younger people and has a higher mortality. The neurological prognosis of patients with SAH is improving with increasingly better understanding of the pathophysiology and management. Cerebral vasospasm has been believed as being the major cause of delayed cerebral ischemia (DCI), but other mechanisms than vasospasm alone have also come to be recognized as being involved in DCI. If DCI or cerebral infarction occurs after SAH, the physical functions are likely to deteriorate. Over the past 60 years, strategies for the prevention and treatment of DCI have been developed, although few have become established in clinical practice. This review provides an overview of the pathophysiology, monitoring, prevention and therapeutic management of DCI.</p>

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