Janardhan Vallabh, Biondi Alessandra, Riina Howard A, Sanelli Pina C, Stieg Philip E, Gobin Y Pierre
New York-Presbyterian Hospital, Weill-Cornell Medical College of Cornell University, 525 E 68th Street, P.O. Box 141, New York, NY 10021, USA.
Neuroimaging Clin N Am. 2006 Aug;16(3):483-96, viii-ix. doi: 10.1016/j.nic.2006.05.003.
Cerebral vasospasm is a major cause of morbidity and mortality associated with subarachnoid hemorrhage (SAH). Advances in neuroimaging and development of newer intraparenchymal monitoring devices have improved the prediction and diagnosis of cerebral vasospasm significantly. Recent experimental and clinical trials have increased the armamentarium of preventive and treatment strategies for cerebral vasospasm. Vasospasm refractory to medical therapy usually is treated endovascularly with percutaneous transluminal balloon angioplasty (PTA) for proximal vessel vasospasm and vasodilator infusion for distal vessel vasospasm. Although vasospasm usually does not recur after PTA, recurrence is frequent after vasodilator infusion. The development of newer microballoon catheters has led to improvements in treatment of not only proximal but also distal vessel vasospasm with balloon angioplasty. This article reports on current knowledge in the diagnosis, prediction, prevention, and management of cerebral vasospasm.
脑血管痉挛是蛛网膜下腔出血（SAH）相关发病和死亡的主要原因。神经影像学的进展以及新型脑实质内监测设备的开发显著改善了脑血管痉挛的预测和诊断。最近的实验和临床试验增加了脑血管痉挛预防和治疗策略的手段。药物治疗无效的血管痉挛通常采用经皮腔内球囊血管成形术（PTA）治疗近端血管痉挛，采用血管扩张剂输注治疗远端血管痉挛。虽然血管痉挛在PTA后通常不会复发，但在血管扩张剂输注后复发很常见。新型微球囊导管的开发不仅改善了近端血管痉挛的球囊血管成形术治疗，也改善了远端血管痉挛的治疗。本文报道了脑血管痉挛诊断、预测、预防和管理的当前知识。
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