| Transluminal angioplasty of intracerebral vessels for cerebral arterial spasm: reversal of neurological deficits after delayed treatment. | |
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MedLine Citation:
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PMID: 2528079 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We used intracerebral transluminal angioplasty to treat two episodes of symptomatic vasospasm in a patient recovering from an aneurysmal subarachnoid hemorrhage. The procedures were performed after medical therapies, intravascular volume expansion, and induced arterial hypertension failed to alleviate the patient's neurological condition. The first angioplasty, confined to the right middle cerebral and distal internal carotid arteries, took place more than 30 hours after the onset of left hemiplegia. Despite the subsequent discovery of a small parietal lobe infarct, it brought about a marked improvement in left motor function and may have also limited the spread of necrotic damage. The second angioplasty was necessitated when stenotic segments of the basilar and posterior cerebral arteries caused a 24-hour decline in the patient's mental status. Although delayed in relation to the onset of symptoms, it successfully reversed the patient's comatose state. The use of transluminal angioplasty for vasospasm is generally limited to cases where it can be performed shortly after the onset of neurological symptoms; delaying the procedure increases the risk of hemorrhage from reperfused areas of infarction. Our experience with this patient demonstrates that delayed angioplasty can improve vascular flow to ischemic territory, even after infarction, without complications and with resultant improvement in neurological function. |
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Authors:
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S L Barnwell; R T Higashida; V V Halbach; C F Dowd; C B Wilson; G B Hieshima |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 25 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 1989 Sep |
Date Detail:
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Created Date: 1989-10-04 Completed Date: 1989-10-04 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 424-9 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, School of Medicine, University of California San Francisco. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Balloon* Brain Ischemia / therapy* Cerebral Angiography Craniotomy Female Humans Intracranial Aneurysm / surgery* Ischemic Attack, Transient / therapy* Middle Aged Postoperative Complications / therapy* Recurrence Subarachnoid Hemorrhage / surgery* Tomography, X-Ray Computed Vertebrobasilar Insufficiency / therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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