Neurosurgery clinics of North America
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Neurosurg. Clin. N. Am. · Jul 2005
ReviewIntensive care unit management of interventional neuroradiology patients.
The management of interventional neurologic patients in the intensive care unit is based on their underlying disease for the most part. Patients with ischemic stroke are largely managed like patients with ischemic stroke who have not undergone interventional procedures, and the same is true for those with an aneurysmal subarachnoid hemorrhage or intracerebral hemorrhage secondary to an arteriovenous malformation, for example. Having said this, there are some special considerations that require special mention when it comes to managing patients after catheter-based procedures.
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Neurosurg. Clin. N. Am. · Jul 2005
ReviewEndovascular treatment of cerebral vasospasm: transluminal balloon angioplasty, intra-arterial papaverine, and intra-arterial nicardipine.
Cerebral vasospasm is still one of the leading causes of morbidity and mortality from subarachnoid hemorrhage. Vasospasm refractory to medical management can be treated with endovascular therapies, such as transluminal balloon angioplasty or infusion of intra-arterial vasodilating agents. ⋯ Intra-arterial nicardipine therapy produced clinical improvement in 42% of patients, significantly improved mean TCD velocities (P <.001) for 4 days, and was associated with no complications in our small series. We have adopted a treatment protocol at our institution of transluminal balloon angioplasty and intra-arterial nicardipine therapy as the endovascular treatments for medically refractory cerebral vasospasm.