Cerebral vasospasm following subarachnoid hemorrhage: Time for a new world of thought

Abstract

Objective: Delayed cerebral vasospasm has long been recognized as an important cause of poor outcome after an otherwise successful treatment of a ruptured intracranial aneurysm, but it remains a pathophysiological enigma despite intensive research for more than half a century. Method: Summarized in this review are highlights of research from North America, Europe and Asia reflecting recent advances in the understanding of delayed ischemic deficit. Result: It will focus on current accepted mechanisms and on new frontiers in vasospasm research. Conclusion: A key issue is the recognition of events other than arterial narrowing such as early brain injury and cortical spreading depression and of their contribution to overall mortality and morbidity. © 2009 W. S. Maney & Son Ltd.