Cerebral vasospasm in subarachnoid haemorrhage

In the second and third weeks after a subarachnoid haemorrhage a series of mechanisms causes a decrease of the diameter of the cerebral vessels. These phenomena are globally included in the term "vasospasm". A certain degree of vasospasm is found in the majority of the patients after a subarachnoid bleeding.. This can be detected by instrumental examinations, in particular trans-cranial doppler and angiography. However, only a minor percentage of these patients will suffer clinical consequences. The vasospasm is currently treated by hypertensive-hypervolemic-haemodilution therapy (the so called "HHH" therapy), or may be treated by selective injection of vasoactive substances (Papaverine, nimodipine) or by mechanical dilatation of the involved vessels with balloons, mainly because of an improved medical management and a better monitoring of critical patients the incidence of clinical vasospasm has decreased in the recent years.