delayed_cerebral_ischemia_after_aneurysmal_subarachnoid_hemorrhage_treatment

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage treatment

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage prevention


see Delayed cerebral ischemia treatment

Aneurysmal subarachnoid hemorrhage treatment


Pharmacologically-induced hypertension combined with volume is the established first-line therapy for DCI; a good clinical response with reversal of the presenting deficit occurs in 70 % of patients. Medically refractory DCI, defined as failure to respond adequately to these measures, should trigger step-wise escalation of rescue therapy. Level 1 rescue therapy consists of cardiac output optimization, hemoglobin optimization, and endovascular intervention, including angioplasty and intra-arterial vasodilator infusion. In highly refractory cases, level 2 rescue therapies are also considered, none of which have been validated 1).


In 2012 Koenig published the Management of delayed cerebral ischemia after subarachnoid hemorrhage 2).


1)
Francoeur CL, Mayer SA. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Crit Care. 2016 Oct 14;20(1):277. doi: 10.1186/s13054-016-1447-6. PMID: 27737684; PMCID: PMC5064957.
2)
Koenig MA. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Continuum (Minneap Minn). 2012 Jun;18(3):579-97. doi: 10.1212/01.CON.0000415429.99394.e8. PMID: 22810250.
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