Effectiveness of the head-shaking method combined with cisternal irrigation with urokinase in preventing cerebral vasospasm after subarachnoid hemorrhage

Abstract

The head-shaking method significantly reduced the incidence of symptomatic vasospasm, cerebral infarction, and permanent ischemic neurological deficit and improved the clinical outcomes in patients who underwent cisternal irrigation therapy after aneurysmal SAH.

Identification of OPN, TNC and E-selectin as potential recognition proteins in cerebral vasospasm after subarachnoid hemorrhage

“…Currently, there are many kinds of treatments for CVS after SAH [13][14][15][16][17][18][19][20][21]. However, these methods can only reduce a part of occurrence of CVS [22].…”

Prospective, Randomized, Open-Label Phase II Trial on Concomitant Intraventricular Fibrinolysis and Low-Frequency Rotation After Severe Subarachnoid Hemorrhage

“…3,4,6,7,[14][15][16][17] However, the majority of these studies also differed in design, as they compared experimental with no treatment for DCI, included mainly good grade SAH patients, or investigated exclusive cisternal and urokinase application. [3][4][5][6][7] The relation of the type of fibrinolytic agent with outcome remains incompletely understood.…”

“…3,4,6,7,[14][15][16][17] However, the majority of these studies also differed in design, as they compared experimental with no treatment for DCI, included mainly good grade SAH patients, or investigated exclusive cisternal and urokinase application. [3][4][5][6][7] The relation of the type of fibrinolytic agent with outcome remains incompletely understood. Despite some animal studies reporting a neurotoxic effect for rt-PA Serious adverse events 0 0 GOS d/c indicates Glasgow Outcome Scale at discharge; GOS 3 months, Glasgow Outcome Scale after 3 months; hydrocephalus, incidence of permanent hydrocephalus requiring ventriculoperitoneal shunt surgery at discharge; new cerebral infarction, cerebral infarction exclusively related to delayed cerebral ischemia; PCT, perfusion computer tomography; PCT VSP, mean transit time values >4.2 s of baseline PCT measurements; rescue therapy, angiographic, intra-arterial nimodipine administration and balloon angioplasty; and VSP, vasospasm.…”

“…[3][4][5][6] Interestingly, kinetic therapy (ie, head-shaking) in addition to cisternal fibrinolysis, was reported to significantly enhance this beneficial effect. 7 However, cisternal fibrinolysis restricted this treatment to patients undergoing surgical repair for a ruptured intracranial aneurysm. Therefore, we studied the effect of intermittent intraventricular fibrinolysis and concomitant lowfrequency head-motion therapy in a randomized, phase II study in patients experiencing severe aneurysmal SAH.…”

Neuroprotective Treatment Strategies for Delayed Cerebral Ischemia after Subarachnoid Hemorrhage – Review of Literature and Future Prospects

“…This form of treatment was first described by Suzuki et al in 1990 and later picked up by Kawamoto et al [74,75]. Kawamoto et al reported about a marked reduction of delayed vasospasm, DIND and DCI and an improvement of neurological outcome by continuous head motion combined with cisternal irrigation.…”