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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Main Authors: Daniel R. Kramer, Jesse L. Winer, B. A. Matthew Pease, Arun P. Amar, William J. Mack
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Neurology Research International
Online Access:http://dx.doi.org/10.1155/2013/415813
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author Daniel R. Kramer
Jesse L. Winer
B. A. Matthew Pease
Arun P. Amar
William J. Mack
author_facet Daniel R. Kramer
Jesse L. Winer
B. A. Matthew Pease
Arun P. Amar
William J. Mack
author_sort Daniel R. Kramer
collection DOAJ
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 doaj-art-fb5ef58c3cf24e63a4e54505b1d108f62025-08-20T02:22:56ZengWileyNeurology Research International2090-18522090-18602013-01-01201310.1155/2013/415813415813Cerebral Vasospasm in Traumatic Brain InjuryDaniel R. Kramer0Jesse L. Winer1B. A. Matthew Pease2Arun P. Amar3William J. Mack4Department of Neurosurgery, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USADepartment of Neurosurgery, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USADepartment of Neurosurgery, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USADepartment of Neurosurgery, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USADepartment of Neurosurgery, University of Southern California, 1200 North State Street, Suite 3300, Los Angeles, CA 90033, USAVasospasm 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.http://dx.doi.org/10.1155/2013/415813
spellingShingle Daniel R. Kramer
Jesse L. Winer
B. A. Matthew Pease
Arun P. Amar
William J. Mack
Cerebral Vasospasm in Traumatic Brain Injury
Neurology Research International
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
url http://dx.doi.org/10.1155/2013/415813
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