To look beyond vasospasm in aneurysmal subarachnoid haemorrhage.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_6EDE0F4179D1
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
To look beyond vasospasm in aneurysmal subarachnoid haemorrhage.
Journal
Biomed Research International
Author(s)
Cossu G., Messerer M., Oddo M., Daniel R.T.
ISSN
2314-6141 (Electronic)
Publication state
Published
Issued date
2014
Volume
2014
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Delayed cerebral vasospasm has classically been considered the most important and treatable cause of mortality and morbidity in patients with aneurysmal subarachnoid hemorrhage (aSAH). Secondary ischemia (or delayed ischemic neurological deficit, DIND) has been shown to be the leading determinant of poor clinical outcome in patients with aSAH surviving the early phase and cerebral vasospasm has been attributed to being primarily responsible. Recently, various clinical trials aimed at treating vasospasm have produced disappointing results. DIND seems to have a multifactorial etiology and vasospasm may simply represent one contributing factor and not the major determinant. Increasing evidence shows that a series of early secondary cerebral insults may occur following aneurysm rupture (the so-called early brain injury). This further aggravates the initial insult and actually determines the functional outcome. A better understanding of these mechanisms and their prevention in the very early phase is needed to improve the prognosis. The aim of this review is to summarize the existing literature on this topic and so to illustrate how the presence of cerebral vasospasm may not necessarily be a prerequisite for DIND development. The various factors determining DIND that worsen functional outcome and prognosis are then discussed.
Pubmed
Open Access
Yes
Create date
02/12/2014 0:41
Last modification date
28/04/2020 6:09
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