In this video, Mayfield's Dr. Andrew Ringer discusses the treatment options for unruptured brain aneurysms
Vasospasm adds insult to injury
When an aneurysm in the brain bursts, it bleeds into the space between the skull and the brain. About 40,000 people suffer a ruptured aneurysm and subsequent subarachnoid hemorrhage in the United States each year. Of those people:
- one-third die
- one-third survive
- one-third survive but with brain damage
Why are the odds so poor? Because 5 to 10 days after the aneurysm ruptures, a life-threatening complication known as vasospasm adds insult to injury.
Blood irritates the lining of the brain. When red blood cells break down, toxins can cause the walls of arteries nearby to narrow and spasm. Vasospasm reduces blood flow to the brain, causing a second stroke.
Vasospasm remains perplexing to doctors, who despite their best efforts are unable to prevent it. Our physicians and researchers are at the forefront of understanding what causes vasospasm and developing better treatments.
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Vasospasm occurs in 70% of patients after a hemorrhage. Of these, 30% have symptoms that require treatment. Signs of vasospasm include weakness in an arm or leg, confusion, sleepiness, or restlessness. To prevent vasospasm, patients are given the drug nimodipine while in the hospital.
If vasospasm is severe, patients may require an injection of vasodilation medication directly into the artery to relax and stop the spasm. This is done through a catheter during an angiogram. Sometimes balloon angioplasty is used to stretch open the artery.