Contemporary Understanding and Management of Cerebral Vasospasm
Contemporary Understanding and Management of Cerebral Vasospasm

Contemporary Understanding and Management of Cerebral Vasospasm


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About the Book

• A Practical Guide.
• Written by clinicians for clinicians.
• Provides real-world information based on current understanding of the disorder.
• The chapter on molecular mechanisms outlines exciting and promising new molecules.
• Appendix provides clinical protocols for Subarachnoid Hemorrhage and Vasospasm along with abbreviations.
• Useful in optimizing treatment options across the world.
• Meant for practitioners and for all those involved in the care of Subarachnoid Hemorrhage patients.

About the Author

Ketan R Bulsara, MD, Director of Neuroendovascular and Skull Base Surgery, Associate Professor, Department of Neurosurgery, Yale-New Haven Hospital,20 York Street , New Haven, CT, 06460,USA Emily J Gilmore, MD, Assistant Professor, Depatment of Neurology, Yale-New Haven Hospital,20 York Street , New Haven, CT, 06460,USA



Table of Contents:
1. The History of Cerebral Vasospasm 1 Milo A Hollingworth, Ketan R Bulsara 2. Definitions and Epidemiology of Vasospasm 4 Hardik Amin, David M Greer 3. Recent Topics and Advances in the Molecular Mechanisms Contributing to Cerebral Vasospasm in Subarachnoid Hemorrhage 8 Robert J Claycomb, Kevin N Sheth Endothelin-1 8; Neuroinflammation and Host Defense 9; Antioxidants and Scavengers of Free Radicals 10; Tenascin-C and Platelet-Derived Growth Factor 10; Inhibition of HMG-CoA Reductase 10; Vasodilators 11; Antiepileptic Drugs 11 4. The Pathophysiology and Pathology of Cerebral Vasospasm Following Subarachnoid Hemorrhage 16 David Y Hwang, Anita J Huttner Anatomic Considerations 16; Morphological Alterations in Cerebral Arteries after Subarachnoid Hemorrhage 17; Pathophysiology of Vasospasm 17 5. Imaging of Vasospasm: The Role of Magnetic Resonance Imaging in Subarachnoid Hemorrhage-Related Vasospasm 23 Amit Mahajan, Michele H Johnson Pathophysiology 23; Techniques and Sequences 24; Magnetic Resonance Perfusion Imaging 24; Limitations of Magnetic Resonance Imaging 26; Hyperacute Magnetic Resonance Imaging Protocol 27; Role of Magnetic Resonance Imaging in Patients with Subarachnoid Hemorrhage 27; Perfusion Imaging 30; Vessel Wall Imaging 30 6. Imaging of Vasospasm: CT, CTA and CTP Correlated with Digital Subtracted Angiography in Cerebral Vasospasm 32 Ajay Malhotra, Michele H Johnson Use of CT, Contrast CT and CTA as Noninvasive Techniques along with TCD and DSA to Identify Probability, Extent and Severity of Vasospasm 33; Technical Features and Scan Acquisition 34; Image Interpretation of Computed Tomography Angiography in Vasospasm 35; Accuracy of Computed Tomography Angiography for Identification and Stratification of Cerebral Vasospasm 38; Computed Tomography Perfusion in Cerebral Vasospasm 38; Limitations, Pitfalls and Problems 40 7. Imaging of Vasospasm: Transcranial Doppler Ultrasound Imaging: Detecting Intracerebral Arterial Vasospasm 43 Jonathan D Kirsch, Michele H Johnson, Leslie M Scoutt Subarachnoid Hemorrhage and Vasospasm Detection 43; Technique 44; Doppler Ultrasound Physics 45; Biosafety 47; Doppler Evaluation of Vasospasm 48; Other Applications of Transcranial Doppler Imaging 52xvi Contemporary Understanding and Management of Cerebral Vasospasm: A Practical Guide 8. Medical Management of Vasospasm 55 Evie Marcolini, Emily J Gilmore Defining the Problem 55; Monitoring and Triggers 55; Triggers for Intervention 56; Hemodynamic Augmentation 57; Calcium Channel Blockers 58; Magnesium 58; Endothelin Receptor Antagonists 58; Statins 58; Nitric Oxide 58; Fever Control 59; Hyponatremia 59; Adrenal Insufficiency 59 9. Electroencephalogram Monitoring of Vasospasm 62 Nicolas Gaspard, Emily J Gilmore, Lawrence J Hirsch Cellular Basis of Electroencephalogram Activity 62; Modifications of Brain Metabolism and Electroencephalogram Activity Secondary to Ischemia 62; Electroencephalogram Studies in Patients with Aneurysmal Subarachnoid Hemorrhage 63; Continuous Electroencephalogram Monitoring for Ischemia Detection 63; Quantitative Electroencephalogram Analysis with the Fast Fourier Transform 64; Artifacts and the use of Intracortical Electroencephalogram 67; Other Confounding Factors and the Need for Multimodality Monitoring 67; Continuous Electroencephalogram for the Monitoring of Treatment 68; Future Developments 68 10. Anesthesia for Neurointerventional Surgery 70 Keith J Ruskin Anesthetic Management 70; Radiation Protection 73 11. Practical Microsurgical and Endovascular Treatment of Vasospasm 75 Ryan A Grant, Ketan R Bulsara, Charles C Matouk Pathogenesis of Cerebral Vasospasm 75; Medical Prevention and Treatment of Cerebral Vasospasm 76 12. Special Populations 85 Lauren A Beslow, Jonathan D Kirsch A. Pediatric Subarachnoid Hemorrhage 85 Lauren A Beslow B. Sickle Cell Disease 86 Jonathan D Kirsch Appendix: Clinical Protocols 89 Subarachnoid Hemorrhage Protocol 89 Vasospasm Protocol 91 Abbreviations 92 Index 95


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Product Details
  • ISBN-13: 9789351525608
  • Publisher: Jaypee Brothers Medical Publishers
  • ISBN-10: 9351525600
  • Publisher Date: 30 Apr 2015


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