Etiology of cerebral vasospasm

Bryce Weir*, R. Loch Macdonald, M. Stoodley

*Corresponding author for this work

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Cerebral vasospasm is a gradual onset and prolonged constriction of the cerebral arteries in the subarachnoid space after subarachnoid hemorrhage. The principal cause is the surrounding blood clot. The significance of vasospasm is that flow through the constricted arteries may be reduced sufficiently to cause cerebral infarction. Subarachnoid blood clot is sufficient to cause vasospasm; it does not require additional arterial injury, intracranial hypertension or brain infarction, although these elements are often coexistent. The blood released at the time of aneurysmal rupture into the alien subarachnoid environment is an extraordinarily complex mix of cellular and extracellular elements that evolves as clotting occurs; cells disintegrate; local inflammation, phagocytosis and repair take place; severe constriction alters the metabolism and structure of the arterial wall as well as the balance of vasoconstrictor and dilator substances produced by its endothelium, neurogenic network and perhaps smooth muscle cells.

Original languageEnglish
Pages (from-to)27-46
Number of pages20
JournalActa Neurochirurgica, Supplement
Volume1999
Issue numberSUPPL. 72
Publication statusPublished - 1999
Externally publishedYes

Keywords

  • Endothelin
  • Hemoglobin
  • Nitric oxide
  • Vasospasm

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