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Protection of the Brain After Aneurysmal Rupture – Richardson Lecture

Published online by Cambridge University Press:  18 September 2015

Bryce Weir
Bryce Weir*
Affiliation:
Department of Neurosurgery, University of Chicago, Chicago, Illinois
*
University of Chicago Medical Center, Section of Neurosurgery, 5841 South Maryland Avenue, Chicago. Illinois USA 60637
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Abstract

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The majority of patients survive the first dangerous hours after an aneurysmal rupture. However, many subsequently succumb as a result of a variety of lethal complications. The most important of these develop as sequelae of the initial ischemia, rebleeding and the delayed onset of vasospasm. Some of these deleterious cascades can be aborted. Since the delayed complications such as vasospastic infarction can be accurately predicted, this is one of rare “strokes” that can have pharmacological pre-treatment. The natural history of rebleeding and vasospasm are described as well as their effects on blood flow, oxygen delivery and metabolism. Strategies to ameliorate acute and delayed ischemia and hypoxia are discussed. Finally, potential pharmacotherapies are detailed.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 22 , Issue 3 , August 1995 , pp. 177 - 186
Copyright
Copyright © Canadian Neurological Sciences Federation 1995

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