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Surgical procedure and results of cisternal washing therapy for the prevention of cerebral vasospasm following SAH.
MedLine Citation:
PMID:  21125454     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
In 1994, we started cisternal washing therapy (CWT) using urokinase combined with head-shaking method in order to prevent cerebral vasospasm. In this paper, we showed the surgical procedure for CWT and reported the effect of this therapy in preventing vasospasm following SAH. A total of 332 consecutive cases with Fisher group 3 SAH since 1988 were analyzed. Of these patients, 118 cases (56 cases before 1994 and 62 cases after 1994) had not CWT, and, 214 cases after 1994 had this therapy. All of these patients had clipping surgery within 3 days following SAH, and had postoperative management both with normovolemia and normal to mild hypertension. In these two groups, the incidence of symptomatic vasospasm (transiently symptomatic vasospasm without infarction), cerebral infarction due to vasospasm on CT, and mortality and morbidity (M&M) due to vasospasm were analyzed. In the group without CWT, the incidences of symptomatic vasospasm, cerebral infarction on CT, and M&M due to vasospasm were 4.2%, 28.8%, and 17.8%, respectively. On the other hand, in the group with CWT, they were 3.7%, 6.5%, and 2.8%, respectively. In the patients with CWT, the incidence of cerebral infarction on CT due to vasospasm and M&M due to vasospasm were significantly (p < 0.05) decreased. CWT was effective in preventing cerebral vasospasm.
Authors:
Tadayoshi Nakagomi; Kazuhide Furuya; Hiroshi Nagashima; Jun-Ichi Tanaka; Teruyuki Ishii; Shigehiko Takanashi; Takeyuki Shinohara; Fumihiro Watanabe; Akiko Ogawa; Norio Fujii; Akira Tamura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  110     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2011  
Date Detail:
Created Date:  2010-12-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  105-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi City, Tokyo, 173-8605, Japan. nsnaka@med.teikyo-u.ac.jp
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