Abstract

FANDINO, J. et al. Perspectives in the treatment of subarachnoid-hemorrhage-induced cerebral vasospasm. Neurocirugía [online]. 2007, vol.18, n.1, pp.16-27. ISSN 1130-1473.

Cerebral vasospasm is still the most important cause of death and disability after rupture of intracranial aneurysms. The therapeutic strategies in the treatment of subarachnoid hemorrhage induced vasos pasm include four groups: 1) prevention of vasospasm; 2) reversion of vasospasm; 3) improvement of cerebral perfusion; and 4) neuroprotection and rescue therapies. Recent experimental studies allowed the design of phase II clinical studies which demonstrated positive results with medications and compounds such as statins (simvastatin and pravastatin) and endothelin-1 receptor antagonists (clasozentan). Moreover, experimental and clinical evidences showed the advantages of early cerebrospinal fluid drainage, intrathecal administration of NO-donors, effects of Ca2+ protein kinase inhibitor (Fasudil) and catecholamines on the cerebral vessels. This review article summarizes the stage of investigation of these medications and therapeutic strategies which will be relevant in the treatment of cerebral vasospasm. " I would caution that vasospasm is still around, it is still alive and living in every neurosurgical unit. Hence my plea that our scientists not falter or lose interest for a final understanding and solution" C.G. Drake,1990 ⁹

Keywords : Subarachnoid hemorrhage; Cerebral vasospasm; Angioplasty; NO donors; Statins; Endothelin receptors antagonists.

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