The Pathogenesis of Cerebral Vasospasm and Its Prevention and Treatment / 国际脑血管病杂志

ABSTRACT

Cerebral vasospasm (CVS) is one of the main causes resulting in death and disability in patients with aneurysmal subarachnoid hemorrhage (SAH). Although CVS has been studied extensively after SAH, its pathogenesis remains uncertain. Decomposed product of erythrocytes, vascular endothelium dysfunction and inflammatory reaction play important roles in it. Cerebrovascular angiography remains the gold standard for diagnosing CVS; however, with the development of neuroimaging technology, the status of some non-invasive methods such as transcranial Doppler, CT and MRI, are more and more important in the diagnosis of SAH and CVS. The management of CVS includes the following 5 aspects (1) the prevention of CVS should be as early as possible after SAH; (2) arterial stenosis should be corrected after the onset of CVS; (3) arterial stenosis caused cerebral ischemia should be prevented; (4) arterial stenosis caused cerebral ischemia should be treated, and (5) brain tissue should be protected from ischemic injury.