scholarly journals Effects of Induced Hypertension on Cerebral Perfusion in Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2015 ◽  
Vol 46 (11) ◽  
pp. 3277-3281 ◽  
Author(s):  
Celine S. Gathier ◽  
Jan Willem Dankbaar ◽  
Mathieu van der Jagt ◽  
Bon H. Verweij ◽  
Annemarie W. Oldenbeuving ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Cerebral Perfusion ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Induced Hypertension

Comparison of Initial Vasopressors Used for Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage

2017 ◽  
Vol 43 (5-6) ◽  
pp. 266-271 ◽  
Author(s):  
Bhaskar Roy ◽  
Louise D. McCullough ◽  
Rajat Dhar ◽  
James Grady ◽  
Yu-Bo Wang ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Adverse Effects ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Response To Therapy ◽  
Discharge Disposition ◽  
Induced Hypertension ◽  
Baseline Characteristics ◽  
The Impact

Background: The main reason for morbidity after aneurysmal subarachnoid hemorrhage (aSAH) is delayed cerebral ischemia (DCI). The mainstay of medical therapy for treating DCI is induced hypertension with vasopressors to restore cerebral perfusion. Both phenylephrine (PE) and norepinephrine (NE) are commonly used for induced hypertension, but the impact of the initial choice of vasopressor on the efficacy, adverse effects, or outcome after hemodynamic therapy for DCI is unknown. Methods: Sixty-three patients with aSAH between January 2012 and October 2014, who developed DCI (defined as new focal deficit or decline in Glasgow Coma Score) and in which PE (n = 45) or NE (n = 18) treatment was initiated were evaluated in this retrospective study. Baseline characteristics, adverse effects, the need to change or add vasopressors, the response to therapy, the need for endovascular therapy, new infarct development, discharge disposition, and 3 months modified Rankin score were all compared between pressor groups. Results: Baseline characteristics (e.g., Hunt Hess and Fisher grades) were similar. There were no differences in the overall rate of complications including arrhythmia, pulmonary edema, or kidney injury. However, those initiated on PE were more likely to be changed to an alternate vasopressor (64 vs. 33%, p = 0.016), mostly for bradycardia or failure to reach therapeutic targets. Patients initially treated with PE were less likely to respond neurologically (71 vs. 94%, p = 0.01) or to be discharged to home or acute rehabilitation facilities (73 vs. 94%, p = 0.02) and were more likely to have a delayed infarct on imaging (62 vs. 33%, p = 0.04). Conclusions: Our study suggests that patients with DCI after aSAH initiated on PE are more likely to require treatment change to another vasopressor and are at greater risk for poor clinical outcomes compared to patients started on NE. Larger comparative studies are warranted.

scholarly journals Diagnostic Threshold Values of Cerebral Perfusion Measured With Computed Tomography for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2010 ◽  
Vol 41 (9) ◽  
pp. 1927-1932 ◽  
Author(s):  
Jan Willem Dankbaar ◽  
Nicolien Karen de Rooij ◽  
Mienke Rijsdijk ◽  
Birgitta K. Velthuis ◽  
Catharine J.M. Frijns ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Cerebral Perfusion ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Threshold Values ◽  
Diagnostic Threshold

scholarly journals Relationship between vasospasm, cerebral perfusion, and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

2009 ◽  
Vol 51 (12) ◽  
pp. 813-819 ◽  
Author(s):  
Jan W. Dankbaar ◽  
Mienke Rijsdijk ◽  
Irene C. van der Schaaf ◽  
Birgitta K. Velthuis ◽  
Marieke J. H. Wermer ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Cerebral Perfusion ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia

scholarly journals Global and focal cerebral perfusion after aneurysmal subarachnoid hemorrhage in relation with delayed cerebral ischemia

2008 ◽  
Vol 50 (9) ◽  
pp. 813-820 ◽  
Author(s):  
M. Rijsdijk ◽  
I. C. van der Schaaf ◽  
B. K. Velthuis ◽  
M. J. Wermer ◽  
G. J. E. Rinkel
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Cerebral Perfusion ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia

scholarly journals Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

Stroke ◽  
2018 ◽  
Vol 49 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Celine S. Gathier ◽  
Walter M. van den Bergh ◽  
Mathieu van der Jagt ◽  
Bon H. Verweij ◽  
Jan Willem Dankbaar ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Induced Hypertension
Sign in / Sign up

Export Citation Format

Share Document