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Intensive Care Management of Aneurysmal Subarachnoid Hemorrhage

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Yearbook of Intensive Care and Emergency Medicine 1999

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1999))

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Abstract

Subarachnoid hemorrhage (SAH) is comprehensively defined as the presence of blood in the subarachnoid space. SAH may be caused by a wide variety of pathologic conditions among which are trauma and secondary subarachnoidal involvement from parenchymal or ventricular hemorrhage. A subtype of SAH corresponding to bleeding of a vessel located in the subarachnoid space is designated as primary or spontaneous SAH. Being in most cases (80–85%) due to the rupture of a cerebral aneurysm, much less frequently to the bleeding of a brain arteriovenous malformation, this kind of SAH is also referred to as aneurysmal SAH.

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References

  1. Weaver JP, Fisher M (1994) Subarachnoid hemorrhage: an update of pathogenesis, diagnosis and management. J Neurol Sci 125:119–131.

    Article  PubMed  CAS  Google Scholar 

  2. Guy J, McGrath BJ, Borel CO, et al (1995) Perioperative management of aneurysmal subarachnoid hemorrhage: Part 1. Operative management. Anesth Analg 81:1060–1072.

    PubMed  CAS  Google Scholar 

  3. Lasner TM, Raps EC (1997) Clinical evaluation and management of aneurysmal subarachnoid hemorrhage. Neuroimaging Clin N Am 7:669–678.

    PubMed  CAS  Google Scholar 

  4. Broderick JP, Brott TG, Duldner JE, et al (1994) Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. Stroke 25:1342–1347.

    Article  PubMed  CAS  Google Scholar 

  5. Mayberg MR, Batjer HH, Dacey R, et al (1994) Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Circulation 90:2592–2605.

    Article  PubMed  CAS  Google Scholar 

  6. Terada T, Kinoshita Y, Yokote H, et al (1997) The effect of endovascular therapy for cerebral arterial spasm, its limitation and pitfalls. Acta Neurochir (Wien) 139:227–234.

    Article  CAS  Google Scholar 

  7. Krivosic-Horber R, Leclerc X, Doumith S, et al (1996) Anesthesia and critical care for endovascular occlusion of ruptured intracranial aneurysms with electrically detachable coils. Ann Fr Anesth Reanim 15:354–358.

    Article  PubMed  CAS  Google Scholar 

  8. Kassell NF, Torner JC, Jane JA, et al (1990) The International Cooperative Study on the Timing of Aneurysm Surgery. Part 2: Surgical results. J Neurosurg 73:37–47.

    Article  PubMed  CAS  Google Scholar 

  9. Kassell NF, Torner JC, Haley EC, et al (1990) The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results. J Neurosurg 73:18–36.

    Article  PubMed  CAS  Google Scholar 

  10. Tsementzis SA, Hitchcock ER (1985) Outcome from ‘rescue clipping’ of ruptured intracranial aneurysms during induction anesthesia and endotracheal intubation. J Neurol Neurosurg Psychiatry 48:160–163.

    Article  PubMed  CAS  Google Scholar 

  11. Pinaud M, Souron R, Lelausque JN, et al (1989) Cerebral blood flow and cerebral oxygen consumption during nitroprusside-induced hypotension to less than 50 mmHg. Anesthesiology 70:255–260.

    Article  PubMed  CAS  Google Scholar 

  12. Giannotta SL, Oppenheimer JH, Levy ML, et al (1991) Management of intraoperative rupture of aneurysm without hypotension. Neurosurgery 28:531–535.

    Article  PubMed  CAS  Google Scholar 

  13. Hunt WE, Hess RM (1968) Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 28:14–20.

    Article  PubMed  CAS  Google Scholar 

  14. Report of World Federation of Neurological Surgeons Committee on a Universal Subarachnoid Hemorrhage Grading Scale (1988) J Neurosurg 68:985–986

    Google Scholar 

  15. Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6:1–9.

    Article  PubMed  CAS  Google Scholar 

  16. Pickard JD, Murray GD, Illingworth R, et al (1989) Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid hemorrhage: British aneurysm nimodipine trial. Br Med J 298:636–642.

    Article  CAS  Google Scholar 

  17. Tettenborn D, Dycka J (1990) Prevention and treatment of delayed ischemic dysfunction in patients with aneurysmal subarachnoid hemorrhage. Stroke 21 (suppl): IV85–IV89.

    PubMed  CAS  Google Scholar 

  18. Meyer FB (1990) Calcium antagonists and vasospasm. Neurosurg Clin N Am 1:367–376.

    PubMed  CAS  Google Scholar 

  19. Solenski NJ, Haley EC Jr, Kassell NF, et al (1995) Medical complications of aneurysmal subarachnoid hemorrhage: a report of the multicenter, cooperative aneurysm study. Crit Care Med 23:1007–1017.

    Article  PubMed  CAS  Google Scholar 

  20. Biller J, Godersky JC, Adams HP Jr (1988) Management of aneurysmal subarachnoid hemorrhage. Stroke 19:1300–1305.

    Article  PubMed  CAS  Google Scholar 

  21. Powers WJ, Grubb RL Jr, Baker RP, et al (1985) Regional cerebral blood flow and metabolism in reversible ischemia due to vasospasm. Determination by positron emission tomography. J Neurosurg 62:539–546.

    Article  PubMed  CAS  Google Scholar 

  22. Macdonald RL, Weir BK (1991) A review of hemoglobin and the pathogenesis of cerebral vasospasm. Stroke 22:971–982.

    Article  PubMed  CAS  Google Scholar 

  23. Nirei H, Hamada K, Shoubo M, et al (1993) An endothelin ETA receptor antagonist, FR139317, ameliorates cerebral vasospasm in dogs. Life Sci 52:1869–1874.

    Article  PubMed  CAS  Google Scholar 

  24. Levy ML, Day JD, Zelman V, Giannotta SL (1994) Cardiac performance enhancement and hypervolemic therapy. Neurosurg Clin N Am 5:725–739.

    PubMed  CAS  Google Scholar 

  25. Levy ML, Rabb CH, Zelman V, Giannotta SL (1993) Cardiac performance enhancement from dobutamine in patients refractory to hypervolemic therapy for cerebral vasospasm. J Neurosurg 79:494–499.

    Article  PubMed  CAS  Google Scholar 

  26. Apostolides PJ, Greene KA, Zabramski JM, Fitzgerald JW, Spetzler RF (1996) Intraaortic balloon pump counterpulsation in the management of concomitant cerebral vasospasm and cardiac failure after subarachnoid hemorrhage: technical case report. Neurosurgery 38:1056–1059.

    Article  PubMed  CAS  Google Scholar 

  27. Levy ML, Giannotta SL (1991) Cardiac performance indices during hypervolemic therapy for cerebral vasospasm. J Neurosurg 75:27–31.

    Article  PubMed  CAS  Google Scholar 

  28. Solomon RA, Fink ME, Pile-Spellman J (1994) Surgical management of unruptured intracranial aneurysms. J Neurosurg 80:440–446.

    Article  PubMed  CAS  Google Scholar 

  29. Oda S, Shimoda M, Sato O (1996) Early aneurysm surgery and dehydration therapy in patients with severe subarachnoid hemorrhage without ICH. Acta Neurochir (Wien) 138:1050–1056.

    Article  CAS  Google Scholar 

  30. Newell DW, Eskridge JM, Mayberg MR, Grady MS, Winn HR (1989) Angioplasty for the treatment of symptomatic vasospasm following subarachnoid hemorrhage. J Neurosurg 71:654–660.

    Article  PubMed  CAS  Google Scholar 

  31. Foley PL, Caner HH, Kassell NF, Lee KS (1994) Reversal of subarachnoid hemorrhage-induced vasoconstriction with an endothelin receptor antagonist. Neurosurgery 34:108–112.

    Article  PubMed  CAS  Google Scholar 

  32. Jan M, Buchheit F, Tremoulet M (1988) Therapeutic trial of intravenous nimodipine in patients with established cerebral vasospasm after rupture of intracranial aneurysms. Neurosurgery 23:154–157.

    Article  PubMed  CAS  Google Scholar 

  33. Haley EC Jr, Kassell NF, Alves WM, Weir BK, Hansen CA (1995) Phase II trial of tirilazad in aneurysmal subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study. J Neurosurg 82:786–790.

    Article  PubMed  Google Scholar 

  34. Kassell NF, Haley EC Jr, Apperson-Hansen C, Alves WM (1996) Randomized, double-blind, vehicle-controlled trial of tirilazad mesylate in patients with aneurysmal subarachnoid hemorrhage: a cooperative study in Europe, Australia, and New Zealand. J Neurosurg 84:221–228.

    Article  PubMed  CAS  Google Scholar 

  35. Sasaki T, Ohta T, Kikuchi H, et al (1994) A phase II clinical trial of recombinant human tissuetype plasminogen activator against cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Neurosurgery 35:597–604.

    Article  PubMed  CAS  Google Scholar 

  36. Hart RG, Byer JA, Slaughter JE, Hewett JE, Easton JD (1981) Occurrence and implications of seizures in subarachnoid hemorrhage due to ruptured intracranial aneurysms. Neurosurgery 8:417–421.

    Article  PubMed  CAS  Google Scholar 

  37. Okuchi K, Fujioka M, Fujikawa A, et al (1996) Rapid natriuresis and preventive hypervolaemia for symptomatic vasospasm after subarachnoid hemorrhage. Acta Neurochir (Wien) 138:951–956.

    Article  CAS  Google Scholar 

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© 1999 Springer-Verlag Berlin Heidelberg

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Treggiari-Venzi, M.M., Romand, JA., Suter, P.M. (1999). Intensive Care Management of Aneurysmal Subarachnoid Hemorrhage. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1999. Yearbook of Intensive Care and Emergency Medicine, vol 1999. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13453-5_31

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  • DOI: https://doi.org/10.1007/978-3-662-13453-5_31

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-65288-5

  • Online ISBN: 978-3-662-13453-5

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