Abstract
Cerebral vasospasm represents one of the most severe complications of subarachnoid hemorrhage (SAH) and consists of the progressive narrowing of intracranial arteries in the acute and subacute phase after the bleeding. The window of time in which the patient is at the highest risk of vasospasm is between day 6 and day 14 after the ictus. The medical management of posthemorrhagic vasospasm, as recommended by the American Heart Association, consists of induced arterial hypertension. In refractory cases or in patients with cardiovascular contraindications for induced hypertension, endovascular treatment with balloon angioplasty or intra-arterial infusion of a vasodilator is recommended (IIa). This treatment is suitable for proximal and focal vasospasm. In this chapter, we discuss the case of a 64-year-old woman who presented with a spontaneous SAH due to the rupture of a paraophthalmic aneurysm. Focal proximal vasospasm was treated with different endovascular techniques. For a diffuse distal vasospasm, a NeuroFlo device was used with good angiographic and clinical outcomes. The treatment of posthemorrhagic vasospasm in general and the use of the NeuroFlo device in particular are the main topics of this chapter.
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Lylyk, I., Bleise, C., Viso, R., Scrivano, E., Lylyk, P. (2019). Paraophthalmic Internal Carotid Artery Aneurysm: Spontaneous Subarachnoid Hemorrhage Caused by the Rupture of a Paraophthalmic Aneurysm, Treated with Coils and Complicated by Severe Vasospasm, Treated with Pharmaceutical Vessel Dilatation and Proximal Balloon Angioplasty; Diffuse Distal Vasospasm Treated with the NeuroFlo Device with Good Clinical Outcome. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-70267-4_119-1
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DOI: https://doi.org/10.1007/978-3-319-70267-4_119-1
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