Postoperative subarachnoid clots and the pattern of cerebral ischemia associated with symptomatic vasospasm

Kumate, Shigehiko; Nakayama, Yoshiya; Yoshinaga, Shinya; Tomonaga, Masamichi

doi:10.1016/s0090-3019(97)00290-5

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…Other investigators have suggested that persistence of clot may be important in determining whether vasospasm develops. 19,39 Since then it has been suggested that larger volumes of clot clear more slowly; 35 however, the results of our study are important because multi-variate and quantitative analysis showed that clot density and the rate of clot clearance contribute independently to vasospasm.…”

Section: Clot Clearancementioning

confidence: 70%

Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage

Reilly

Amidei

Tolentino³

et al. 2004

Journal of Neurosurgery

168

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Section: Clot Clearancementioning

confidence: 70%

Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage

Reilly

Amidei

Tolentino³

et al. 2004

Journal of Neurosurgery

168

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“…The study is limited to its assessment of factors included in the database and to the method of coding used for the data. 36 For example, raw data on aneurysm size were not available and, thus, aneurysm size had to be analyzed categorically. Clot clearance rate and density, cigarette smoking and various metabolic factors-some of which were found to predict development of vasospasm-could not be assessed ( Table 5).…”

Section: Limitations Of This Analysismentioning

confidence: 99%

Factors associated with the development of vasospasm after planned surgical treatment of aneurysmal subarachnoid hemorrhage

Macdonald¹,

Rosengart²,

Huo³

et al. 2003

Journal of Neurosurgery

114

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Symptomatic vasospasm was associated with the amount of SAH on the CT scan, the presence of IVH, and the patient's neurological grade. The association with patient age may reflect alterations in vessel reactivity associated with age. A history of hypertension may render the brain more susceptible to symptoms from vasospasm. The explanation for the relationships with aneurysm size, use of prophylactic induced hypertension, and the particular study is unclear.

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“…8 , 9 Additionally, nimodipine also has the effects on anti-free radical injury and antagonistic effect on endothelin neurotoxicity, thus improving the tolerance of nerve cells to ischemia and hypoxia, and improving neurological functions, reducing cerebral ischemia-caused death and global cerebral infarction after SAH, and, consequently, effectively improving prognosis. 10 , 11 Several meta-analyses have evaluated the efficacy of nimodipine in the treatment of SAH. Vergouwen et al 12 found no effect of nimodipine on the prognosis of patients with traumatic SAH by including five studies in their analysis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of nimodipine in the treatment of subarachnoid hemorrhage: a meta-analysis

et al. 2022

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Background Subarachnoid hemorrhage (SAH) is an uncommon and serious subtype of stroke, which leads to the loss of the patient's ability to produce and live for many years. Objective To investigate the clinical effect of nimodipine in the treatment of SAH. Methods Electronic databases including China National Knowledge Infrastructure (CNKI), VIP, SinoMed, China Master's Theses Full-text Database (CMFD), China Doctoral Dissertations Full-text Database (CDFD), Cochrane Library, PubMed and Embase were searched from 2010 and 2021. All randomized controlled trials evaluating the efficacy of nimodipine in the treatment of SAH were included in our meta-analysis. The patients were divided into control group and treatment group. Meta-analysis was performed with Stata16.0 software. Results A total of 10 studies were included. Compared with the control group, the treatment group had higher effective rate (OR = 3.21, 95% CI: 2.25, 4.58; p < 0.001), and lower incidence of adverse reactions (OR = 0.35, 95% CI: 0.19, 0.67; p = 0.001). Before treatment, no significant differences were identified in middle cerebral artery blood flow velocity and Glasgow coma scale (GCS) score between the two groups. However, after treatment, the middle cerebral artery blood flow velocity (SMD = −1.36, 95% CI: −2.28, −0.49; p = 0.002) and GCS score (SMD = 1.24, 95% CI: 0.58, 1.89; p < 0.001) in the treatment group were significantly better than those in the control group. Conclusions Nimodipine is effective in the treatment of SAH, lowering incidence of adverse reactions and therefore improving the prognosis of patients.

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Postoperative subarachnoid clots and the pattern of cerebral ischemia associated with symptomatic vasospasm

Cited by 8 publications

References 6 publications

Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage

Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage

Factors associated with the development of vasospasm after planned surgical treatment of aneurysmal subarachnoid hemorrhage

Efficacy of nimodipine in the treatment of subarachnoid hemorrhage: a meta-analysis

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