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Cerebral Vasospasm in Traumatic Brain Injury

Vasospasm following traumatic brain injury (TBI) may dramatically affect the neurological and functional recovery of a vulnerable patient population. While the reported incidence of traumatic vasospasm ranges from 19%–68%, the true incidence remains unknown due to variability in protocols for its de...

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Autores principales: Kramer, Daniel R., Winer, Jesse L., Pease, B. A. Matthew, Amar, Arun P., Mack, William J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703898/
https://www.ncbi.nlm.nih.gov/pubmed/23862062
http://dx.doi.org/10.1155/2013/415813
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author Kramer, Daniel R.
Winer, Jesse L.
Pease, B. A. Matthew
Amar, Arun P.
Mack, William J.
author_facet Kramer, Daniel R.
Winer, Jesse L.
Pease, B. A. Matthew
Amar, Arun P.
Mack, William J.
author_sort Kramer, Daniel R.
collection PubMed
description Vasospasm following traumatic brain injury (TBI) may dramatically affect the neurological and functional recovery of a vulnerable patient population. While the reported incidence of traumatic vasospasm ranges from 19%–68%, the true incidence remains unknown due to variability in protocols for its detection. Only 3.9%–16.6% of patients exhibit clinical deficits. Compared to vasospasm resulting from aneurysmal SAH (aSAH), the onset occurs earlier and the duration is shorter. Overall, the clinical course tends to be milder, although extreme cases may occur. Traumatic vasospasm can occur in the absence of subarachnoid hemorrhage. Surveillance transcranial Doppler ultrasonography (TCD) has been utilized to monitor for radiographic vasospasm following TBI. However, effective treatment modalities remain limited. Hypertension and hypervolemia, the mainstays of treatment of vasospasm associated with aSAH, must be used judiciously in TBI patients, and calcium-channel blockers have offered mixed clinical results. Currently, the paucity of large prospective cohort studies and level-one data limits the ability to form evidence-based recommendations regarding the diagnosis and management of vasospasm associated with TBI.
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spelling pubmed-37038982013-07-16 Cerebral Vasospasm in Traumatic Brain Injury Kramer, Daniel R. Winer, Jesse L. Pease, B. A. Matthew Amar, Arun P. Mack, William J. Neurol Res Int Review Article Vasospasm following traumatic brain injury (TBI) may dramatically affect the neurological and functional recovery of a vulnerable patient population. While the reported incidence of traumatic vasospasm ranges from 19%–68%, the true incidence remains unknown due to variability in protocols for its detection. Only 3.9%–16.6% of patients exhibit clinical deficits. Compared to vasospasm resulting from aneurysmal SAH (aSAH), the onset occurs earlier and the duration is shorter. Overall, the clinical course tends to be milder, although extreme cases may occur. Traumatic vasospasm can occur in the absence of subarachnoid hemorrhage. Surveillance transcranial Doppler ultrasonography (TCD) has been utilized to monitor for radiographic vasospasm following TBI. However, effective treatment modalities remain limited. Hypertension and hypervolemia, the mainstays of treatment of vasospasm associated with aSAH, must be used judiciously in TBI patients, and calcium-channel blockers have offered mixed clinical results. Currently, the paucity of large prospective cohort studies and level-one data limits the ability to form evidence-based recommendations regarding the diagnosis and management of vasospasm associated with TBI. Hindawi Publishing Corporation 2013 2013-06-19 /pmc/articles/PMC3703898/ /pubmed/23862062 http://dx.doi.org/10.1155/2013/415813 Text en Copyright © 2013 Daniel R. Kramer et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Kramer, Daniel R.
Winer, Jesse L.
Pease, B. A. Matthew
Amar, Arun P.
Mack, William J.
Cerebral Vasospasm in Traumatic Brain Injury
title Cerebral Vasospasm in Traumatic Brain Injury
title_full Cerebral Vasospasm in Traumatic Brain Injury
title_fullStr Cerebral Vasospasm in Traumatic Brain Injury
title_full_unstemmed Cerebral Vasospasm in Traumatic Brain Injury
title_short Cerebral Vasospasm in Traumatic Brain Injury
title_sort cerebral vasospasm in traumatic brain injury
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703898/
https://www.ncbi.nlm.nih.gov/pubmed/23862062
http://dx.doi.org/10.1155/2013/415813
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