Document Detail


Innovations in aneurysmal subarachnoid hemorrhage: intracisternal t-PA for the prevention of vasospasm.
MedLine Citation:
PMID:  8718759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Aneurysmal subarachnoid hemorrhage (SAH) affects approximately 30,000 people each year in North America. At least 30% of these patients will develop vasospasm as a result of the initial hemorrhage, and two thirds of these develop permanent disabilities or die. Blood deposited into the basal cisterns from the ruptured aneurysm can form thick clots around the major cerebral vessels. The by-products of the hemolyzed clots are believed to be responsible for the subsequent development of vasospasm. Hypervolemic, hypertensive, hemodilution therapy (HHHT) and nimodipine may improve outcome in some cases but there is no therapy known to prevent vasospasm in all patients. One potential therapeutic agent under investigation is tissue plasminogen activator (t-PA), a fibrinolytic enzyme. Instilled into the basal cisterns at time of aneurysm clipping, t-PA dissolves the clot so spasmogenic substances may be removed, thus preventing or reducing the severity of vasospasm.
Authors:
T E Bell; G L Kongable
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses     Volume:  28     ISSN:  0888-0395     ISO Abbreviation:  J Neurosci Nurs     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-10-01     Completed Date:  1996-10-01     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8603596     Medline TA:  J Neurosci Nurs     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  107-13     Citation Subset:  IM; N    
Affiliation:
Stanford University Medical Center, California 94305, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aneurysm, Ruptured / complications*
Cisterna Magna*
Female
Humans
Instillation, Drug
Intracranial Aneurysm / complications*
Ischemic Attack, Transient / etiology*,  prevention & control
Male
Plasminogen Activators / therapeutic use*
Subarachnoid Hemorrhage / complications,  drug therapy*,  radiography
Tissue Plasminogen Activator / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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