Cerebral vasospasm

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As cerebral vasospasm the spasmodic constriction of arteries of the brain called.

root cause

Cerebral vasospasm is a common and serious complication of subarachnoid hemorrhage . Cerebral vasospasms also occur in other neurological diseases and occur in certain types of poisoning (e.g. ergotism ). However, they can also be caused by medical measures, as a side effect of medication or in connection with drug use (especially cocaine and methamphetamine ).

It is assumed that the blood that has got into the subarachnoid space , when it breaks down ( hemolysis ), releases substances that trigger an insurmountable contraction of the arteries and temporarily disable the autoregulation . Typically, cerebral vasospasm occurs on the fourth day after a subarachnoid hemorrhage and persists for several weeks.

Whether and to what extent vasospasms occur primarily depends on the amount of blood that has leaked. As a result, parts of the brain may be insufficiently supplied with blood, leading to a secondary cerebral infarction .

Prophylaxis and therapy

The vasospasm is difficult to treat. The administration of nimodipine is currently recommended, but triple H therapy ( hypertension - hypervolaemia - hemodilution ) is controversial.

See also

literature

  • Hans Anton Adams, Eberhard Kochs, Claudia Spies: Anesthesiology. Thieme, 2008. ISBN 978-3-13-157082-6 . P. 667
  • Andreas Raabe, Veit Rohde: Vascular neurosurgery. Functional neurosurgery. Thiema, 2008. ISBN 978-3-13-146431-6 . P. 56ff.

Individual evidence

  1. ^ A b Andreas Raabe, Veit Rohde: Vascular Neurosurgery. Functional neurosurgery. Thiema, 2008. ISBN 978-3-13-146431-6 . P. 56ff.
  2. ↑ Jürgen Peiffer, Johann Michael Schröder , Werner Paulus: Neuropathology: Morphological diagnosis of diseases of the nervous system and the skeletal muscles. Springer, Berlin and Heidelberg 2002. ISBN 978-3-642-63-951-7 . P. 141f.
  3. ↑ Hans-Christoph Diener: The stroke. Georg Thieme Verlag, Stuttgart 2004. ISBN 3-13-136291-X . P. 149
  4. ↑ Gustav Paumgartner: Therapy for internal diseases. Springer, 1999. ISBN 978-3-662-10478-1 . P. 1164
  5. ↑ cf. Kristin Engelhard: Farewell to the "Triple-H". Current guidelines. ( Memento of November 27, 2015 in the Internet Archive ) Presentation, December 6, 2013.