Open AccessCerebral Vasospasm after Head Injury
Author(s) -
A. Pasqualin,
C. Vivenza,
L. Rosta,
Claudio Licata,
Paolo Cavazzani,
R. Da Pian
Publication year - 1984
Publication title -
neurosurgery/neurosurgery online
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.485
H-Index - 34
eISSN - 1081-1281
pISSN - 0148-396X
DOI - 10.1097/00006123-198412000-00015
Subject(s) - medicine , vasospasm , subarachnoid hemorrhage , head injury , hematoma , digital subtraction angiography , cerebral vasospasm , subarachnoid space , anesthesia , cistern , angiography , radiology , surgery , cerebrospinal fluid , history , archaeology
Cerebral vasospasm occurs frequently after head injury. Correlation between neurological deterioration and vasospasm has been reported previously, but delayed neurological deterioration secondary to vasospasm in head injury is a rare occurrence. We report the case of a 57-year-old man who, after a motorcycle accident, developed an acute subdural hematoma and a thick subarachnoid deposition of blood in the left sylvian-insular cistern. After surgical evacuation of the hematoma, the patient improved until the 10th postoperative day, when he developed aphasia and a right hempiparesis. Angiography demonstrated multitapering spasm, and a computed tomographic (CT) scan showed persistence of the cisternal deposition of blood. Despite therapy with hypervolemia, the patient improved only slightly. The association of head injury with substantial subarachnoid hemorrhage producing vasospasm has been considered rarely. Delayed posttraumatic vasospasm secondary to blood degradation products seems to play some role in the vasospasm after head injury. CT scanning may be useful in predicting vasospasm in such patients, and digital subtraction angiography might be useful in demonstrating it.