What is Cerebral Vasospasm?


It is the narrowing or reduction of caliber of the intracranial vessels that can occur during the evolution of a patient who has suffered meningeal hemorrhage. It usually occurs between the third and twelfth days after bleeding.

This reduction in size is a result of contraction of the muscle fibers of the cerebral arteries and this contraction, in turn, comes from the action of products generated in the resorption of the blood of meningeal hemorrhage. The breakdown products of blood in the subarachnoid space act as “irritating” to the cerebral vessels. 30% of surviving patients with meningeal hemorrhage may develop ischemia (deficiency of nutrients in a specific organ or part of it by lack of blood flow and may result in the destruction of this body or its part) because it can be so intense vasospasm which prevents the circulation of blood vessel or cerebral vessels, thus bringing some degree of sequelae for the patient.

It is extremely important to follow up the patient with meningeal hemorrhage with the performance of transcranial Doppler ultrasound by a qualified professional. This test can detect vasospasm before clinical symptoms and promote it serves to determine the outcome of treatment implemented.

The vasospasm can be treated clinically by maneuvers such as increased blood pressure, use of vasodilator substances (nimodipine, papaverine), increased blood volume (total amount of blood within the vessels) and can only be addressed effectively if the aneurysm is occluded, surgery or embolization, because increasing blood pressure, blood volume and use vasodilators may promote rebleeding if the aneurysm is not occluded, worsening the patient’s condition.

When medical therapy is ineffective the Interventional Neuroradiology can make a mechanical angioplasty (balloon angioplasty accommodating itself to this function) or chemical angioplasty (local intra-arterial injection of vasodilator substances) if the mechanic is not possible.

All these maneuvers and intensive care of these patients in a referral center and a specialized unit trained and qualified personnel, increases survival of patients and reduces the chances of complications.

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