Diagnosis and treatment of postoperative cerebral vasospasm.

A series of 17 patients who developed severe neurologic deficit due to postoperative cerebral vasospasm is presented. All underwent confirmatory postoperative cerebral angiography. Treatment included controlled hypertension, hyperventilation, over-transfusion of whole blood and colloids, and infusion of low molecular weight dextran. Neurologic deficits were reversed promptly and completely in 12 patients and partially in three patients. The authors propose that methods designed to increase cerebral blood flow can reverse the ischemic deficits of vasospasm.