Vasospasms


Experts at the Center for Endovascular Surgery specialize in evaluating and treating cerebral vasospasms. Vasospasms occurs when a brain blood vessel spasms and the vessel wall becomes severely constricted, blocking blood flow. Vasospasm, which can lead to ischemic stroke, is a complication that can occur in the two weeks following a subarachnoid hemorrhage or brain aneurysm.

 

Who Is At Risk For Cerebral Vasospasms?

Factors that increase the risk for cerebral vasospasms include:

 

What Are The Symptoms Of Cerebral Vasospasms?
  • Fever
  • Neck stiffness
  • Mild confusion
  • Speech impairment
  • Paralysis on one side of the body
  • Severely impaired consciousness
  • Classic cerebrovascular disease (stroke) symptoms

 

How Do Doctors Diagnose Cerebral Vasospasms?

The Center’s physicians closely monitor any patient recovering from treatment of a subarachnoid hemorrhage or brain aneurysm. Based on the patient’s vasospasm symptoms, the Center’s physicians may perform the following tests:

  • Cerebral angiography, a test when X-rays are taken of the brain after a dye is injected into it through a catheter threaded through the groin, is often the best way to detect vasospasms.
  • A review of the CT scan at the time of the subarachnoid hemorrhage or brain aneurysm can be helpful. Studies show that the amount of blood on the original CT scan can correlate with the likelihood of a vasospasm occurring. A new CT scan during the post-treatment period following a subarachnoid hemorrhage or brain aneurysm may also be indicated.
  • Transcranial Doppler ultrasound, which is used to look at blood flow through the skull, is efficient, non-invasive and can be done at bedside. It is often used to regularly follow at-risk patients for the development and progression of vasospasms.
  • An MRI (magnetic resonance imaging) of the brain can help to show how much of the brain tissue has been damaged by the vasospasm.

 

What Are The Treatment Options For Cerebral Vasospasms?

Physicians at the Center for Endovascular Surgery carefully monitor patients recovering from treatment of subarachnoid hemorrhage or brain aneurysm for signs of developing cerebral vasospasm. Preventively, physicians may follow one or more of the following approaches:

  • A preventive course of oral calcium channel blockers has shown promise in preventing vasospasm for those recovering subarachnoid hemorrhage and brain aneurysm.
  • In appropriate cases (most effectively in those who have had their brain aneurysm surgically clipped or coiled), HHH therapy may be recommended. HHH stands for hypervolemic-hypertensive-hemodilution therapy, a process by which the patient’s fluids and blood concentration are carefully balanced to improve brain blood flow.

If a developing vasospasm is suspected, physicians may use one or more of the following strategies:

  • A vasodilating agent, delivered to the site via catheter.
  • Transluminal angioplasty (often called balloon angioplasty), in which a small balloon is attached to a catheter, which in turn is threaded through an area until it reaches the vasospasm site. The balloon is then inflated to break down the blockage.

For help locating a physician at the Center for Endovascular Surgery, contact our Physician Referral Service, Monday through Friday, 9am to 5pm at 212-241-3400.

After hours, you may leave a name and callback number. We will call you back the next business day.

The above number is not for emergencies.


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