• P Rama-Maceiras, N Fàbregas Julià, I Ingelmo Ingelmo, J Hernández-Palazón, and Grupo Ad Hoc de la Sección de Neurociencia de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor.
• Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario A Coruña. prmaceiras@wanadoo.es
• Rev Esp Anestesiol Reanim. 2010 Dec 1; 57 Suppl 2: S44-62.

AbstractThe high rates of morbidity and mortality after subarachnoid hemorrhage due to spontaneous rupture of an intracranial aneurysm are mainly the result of neurologic complications. Sixty years after cerebral vasospasm was first described, this problem remains unsolved in spite of its highly adverse effect on prognosis after aneurysmatic rupture. Treatment is somewhat empirical, given that uncertainties remain in our understanding of the pathophysiology of this vascular complication, which involves structural and biochemical changes in the endothelium and smooth muscle of vessels. Vasospasm that is refractory to treatment leads to cerebral infarction. Prophylaxis, early diagnosis, and adequate treatment of neurologic complications are key elements in the management of vasospasm if neurologic damage, lengthy hospital stays, and increased use of health care resources are to be avoided. New approaches to early treatment of cerebral lesions and cortical ischemia in cases of subarachnoid hemorrhage due to aneurysm rupture should lead to more effective, specific management.

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