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Topic: Vasospasm

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	Basilar Vasospasm Diagnosis: Investigation of a Modified "Lindegaard Index" Based on Imaging Studies and Blood ... (Site not responding. Last check: 2007-10-29)
		of the TCD in the diagnosis of BA vasospasm.
		was indicative of BA vasospasm in 92.8% with 3 false-positive
		Spasm of basilar and vertebral arteries caused by experimental subarachnoid hemorrhage.
	intl-stroke.ahajournals.org /cgi/content/full/33/1/72 (4006 words)

	Nimotop(R): About SAH: Cerebral Vasospasm
		Treatment is also needed to prevent delayed ischemic deficit associated with cerebral vasospasm, the narrowing of the large capacitance arteries at the base of the brain that leads to reduced perfusion of distal brain regions.
		Vasospasm appears due to the presence of blood in the CSF; oxyhemoglobin released by disintegrating erythrocytes may be the source of the substance(s) that interacts with the cerebral vasculature to produce arterial narrowing.
		The term vasospasm may be a misnomer, because the arterial narrowing may be secondary to structural changes of the cerebral blood vessels.
	www.nimotopusa.com /about/cerebral.html (603 words)

	Cerebral Vasospasm
		Vasospasm is responsible for 10-20% of adverse outcomes (excluding the initial hemorrhage).
		Hypothesis suggests that vasospasm persists beacuse of arterial wall stiffening and that this is due to fibrosis in the arterial wall.
		Vasospasm might result from continuous activation of protein kinase C by high levels of diacyl glycerol produced continuously by lipid peroxidation within the smooth muscle cell membrane.
	www.ucsf.edu /nreview/05-Vascular/Vasospasm.html (2208 words)

	VASOSPASM: A PRIMER FOR PATIENTS
		It is essentially an overview of vasospasm, or narrowing of the blood vessels, and the symptoms and treatment with respect to this condition in the brain and, by implication, elsewhere in the body.
		Vasospasm may occur in all of the parts of the body at the same time or in only certain parts of your body at specific times.
		Vasospasm has been identified in all of these conditions and the patients have improved with treatment oriented to causing the blood vessels to dilate.
	www.medforum.com /lifeline/articles/nvs00010/article.html (1288 words)

	AANS.org \| Education and Meetings \| AANS Scientific Journals \| Neurosurgical Focus
		Cerebral vasospasm as a sequel to aneurysmal subarachnoid hemorrhage (SAH) is a well-known entity.
		A 25% decrease in the vessel diameter was defined as mild vasospasm, moderate vasospasm as a narrowing of the vessel by 50%, and severe vasospasm as a narrowing by 75%.
		In the present population angiographically determined vasospasm was found to be mild in 15 patients (21.74%), moderate in 32 (46.38%), and severe in 22 (31.88%).
	www.aans.org /education/journal/neurosurgical/october98/5-4-6.asp?ShowMenu=false&ShowPrint=false (4727 words)

	Cerebral Vasospasm: Current Thinking & Future Trends
		The term "cerebral vasospasm" is commonly used to refer to both the clinical picture of delayed onset of ischemic neurological deficits associated with aneurysmal SAH ("symptomatic vasospasm") and the narrowing of cerebral vessels documented by angiography or other studies ("angiographic or arterial vasospasm").
		Symptomatic vasospasm typically begins 4-5 days after the hemorrhage and is characterized by the insidious onset of confusion and a decreasing level of consciousness.
		Although the identity of the primary spasmogen is still controversial, the bulk of the evidence points to oxyhemoglobin and the involvement of oxygen free radicals in initiating a cascade of reactions that culminate in prolonged vascular smooth muscle contraction.
	www.medschool.lsuhsc.edu /neurosurgery/nervecenter/spasm.html (1596 words)

	CEREBRAL VASOSPASM
		At the time of initiation of treatment for the cerebral vasospasm, at which time vasoactive medications were administered after the baseline TCD and neuro exam was obtained, repeat TCD exams were carried out and when medication effects on the intracranial circulation were identified, repeat neurological exams were obtained.
		TCD exams in all patients showed evidence of generalized cerebral vasospasm as identified by Mean Flow Velocities of greater than 0.6 meters/second in intracranial vessels (0.4 meters/second for vertebrobasilar system) and prolonged diastolic flow component in which continued elevation of diastolic flow beyond end diastolic velocity occurred throughout the entire course of diastole.
		This paper is not meant as a recipe for the treatment of cerebral vasospasm on the outpatient basis, but instead is meant to incite further study into the mechanism of these findings in disparate conditions and possibilities for treatment.
	www.medforum.com /lifeline/articles/pain00003/nvs00001/article.html (3428 words)

	kellymom.com :: Nipple blanching and vasospasm
		Vasospasm, which is more severe, is a sudden constriction/narrowing of a blood vessel (in the nipple, in this case) that is extremely painful.
		Vasospasm due to Raynaud's is more likely to occur on both sides (rather than just one nipple), lasts for relatively long periods of time (rather than for a few seconds or a few minutes), and can occur during pregnancy and/or at times unrelated to feeding.
		Other sources feel that vasospasms experienced by mothers taking fluconazole are a result of nipple pain/trauma due to thrush (and not due to the medication used to treat the thrush).
	www.kellymom.com /bf/concerns/mom/nipple-blanching.html (1179 words)

	Cerebral Vasospasam
		Vasospasm and pathological vasoconstriction are disease states that have a severe impact on the health and well being of a large part of the population.
		Vasospasm and pathological vasoconstriction are linked by an abnormal contraction of the vessel (of unknown aetiology), that is frequently associated with a diminished ability to relax.
		Vasospasm and vasoconstriction therefore, pose a serious health risk, and to date there has been very little information concerning the energy metabolism of different vascular beds with regard to this phenomenon.
	www.med.uc.edu /neurology/ClarkWebsite/b8c.htm (807 words)

	Critical Care Nurse: Vasospasm after aneurysmal subarachnoid hemorrhage (Site not responding. Last check: 2007-10-29)
		Symptomatic vasospasm, also referred to as delayed ischemic deficits, (12) delayed ischemic neurological defects, (13) and cerebrovascular spasm, (4) is the most common serious complication after aneurysmal rupture and is the leading cause of death for patients who survive the rupture.
		Clinical vasospasm is the functional manifestation of cerebral ischemia produced by this arterial narrowing.
		A well-accepted predictive factor of vasospasm is the initial size of the SAH evident on CT scans.
	www.findarticles.com /p/articles/mi_m0NUC/is_5_24/ai_n6332745 (1388 words)

	Presentation # 29 - Nitric Oxide and vasospasm (Site not responding. Last check: 2007-10-29)
		Figure 4B depicts the degree of arteriographic vasospasm of the right MCA on Day 7 (mean value of the right MCA area reduction compared with the preoperative area on the AP arteriogram).
		Vasospasm resolved, as is the normal course in this model, on day 14 (the mean reduction of the R MCA area on the AP view was 3 ± 13% in saline group and 2 ± 12% in L-arginine group; P = 0.2).
		Pluta R, Oldfield E, and Boock R: Reversal and prevention of cerebral vasospasm by intracarotid infusions of nitric oxide donors in a primate model of subarachnoid hemorrhage.
	www.uclm.es /inabis2000/symposia/files/029/session.htm (2888 words)

	Subarachnoid Hemorrhage \| Mayfield Clinic (Site not responding. Last check: 2007-10-29)
		Vasospasm narrows the artery and reduces the blood flow to the region of the brain that artery feeds.
		If vasospasm is suspected the doctor will use a transcranial doppler (TCD) ultrasound to measure the flow of blood through the arteries.
		vasospasm: abnormal narrowing or constriction of arteries due to irritation by blood in the subarachnoid space.
	www.mayfieldclinic.com /PE-SAH.HTM (1403 words)

	New study suggests role for clazosentan in the prevention of cerebral vasospasm after aneurysmal SAH
		Vasospasm occurs 5-14 days following SAH and leads to strokes and neurological deficits that cause significant disability to patients and is a major cause of death.
		The vasospasm following SAH occurs when the acute rupture of an aneurysm of the cerebral vessels releases blood into the subarachnoid space of the brain.
		Endothelin, a known mediator of vasospasm in the cerebral vasculature, provides a rationale for the use of clazosentan, an intravenous endothelin receptor antagonist, for the prevention of vasospasm.
	www.eurekalert.org /pub_releases/2005-07/pf-nss070105.php (1009 words)

	Posttraumatic Vasospasm: Is It Important (Site not responding. Last check: 2007-10-29)
		From studies of vasospasm after aneurysmal rupture it is well known that the amount of subarachnoid blood correlates strongly with severity of vasoconstriction.
		Significance of inflammation was suggested by demonstration of increased inteleukins concentration in the cerebrospinal fluid of the patients with SAH [32], by increased collagen deposition in the vessel wall [22], and by limited effects of anti-inflammatory drugs on the cause of experimental vasospasm [36].
		Vasospasm was found in 20% of patients with mild tSAH and 63% of patients with massive tSAH.
	www.neuro.neva.ru /English/Issues/Articles_1_2001/zubkov.htm (1944 words)

	Neurological Research: Improved rat model for cerebral vasospasm studies (Site not responding. Last check: 2007-10-29)
		Since there is a positive correlation between severity of cerebral vasospasm, and volume of subarachnoid blood, an obvious question is whether the rat will show modifications in vascular responses when insulted by a second SAH.
		The leading cause of death and disability in patients suffering from aneurysmal subarachnoid hemorrhage (SAH) is cerebral vasospasm, a persistent, progressive, and often irreversible constriction of cerebral arteries1-4.
		The primary problem with the rat model is that the timecourse and pattern of cerebral vasospasm after SAH is not comparative to that observed in man9.
	www.findarticles.com /p/articles/mi_qa3909/is_200110/ai_n8957271 (1348 words)

	The Brain Aneurysm Foundation >> Information
		Vasospasm typically develops 5-8 days after the initial hemorrhage.
		To treat vasospasm, blood pressure is often elevated with medicines.
		Certain medications are given to ease the threat of vasospasm.
	www.bafound.org /info/subarachnoid.php (599 words)

	Interventional Neuroradiology ~ Endovascular Treatment of Cerebral Vasospasm
		Cerebral vasospasm remains a significant causing of death and disability among patients surviving subarachnoid hemorrhage from cerebral aneurysms.
		A number of reasonably large series reporting the results of balloon angioplasty for the treatment of cerebral vasospasm after subarachnoid hemorrhage are now available in the literature (Brothers 1990, Takahashi, 1990, Higashida 1992, Eskridge 1994).
		Importantly, the effect of angioplasty in the setting of cerebral vasospasm has been found to be lasting, and re-treatments are rarely, if ever, needed.
	neurosurgery.mgh.harvard.edu /Interventional/INRspams.htm (1248 words)

	Programs
		Vasospasm was managed with hypertensive, hemodilutional, and hypervolemic therapy in an ICU setting, with endovascular treatment used in 39 patients.
		Of the group of 177 patients with vasospasm, 128 (72%) had excellent or good outcome, 19 (11%) had fair outcome, and 6 (3%) had poor outcome, with 24 deaths (14%).
		Using the modified grading system, the in-cidence of vasospasm was found to increase with each grade: Grade 0: 1/10 patients (10%) had TCD vasospasm; Grade 1: 1/7 (14%); Grade 2: 3/8 (38%); Grade 3: 14/28 (50%); and Grade 4: 18/30 (60%).
	brain.mgh.harvard.edu /programs.htm (1040 words)

	Vasospasm
		This year, the two won an award from the Congress of Neurologic Surgeons for their vasospasm work.
		The idea is to place the wafer in the subarachnoid space during necessary surgery to clip the aneurysm.
		It centers on giving animals antibodies to block molecules that increase dramatically-either on the interior of blood vessels or on white blood cells-when there's pooled or clotted blood.
	www.neuro.jhmi.edu /BrainWaves/Winter2004/vasospasm.htm (519 words)

	SSRIs increase post-hemorrhagic vasospasm
		The patients were admitted to hospital between 1995 and 2003, and all were evaluated for vasospasms between days 4 and 14.
		In all, 62% of patients developed vasospasm, with 29% diagnosed with symptomatic vasospasm.
		Specifically, SSRIs doubled the risk for all vasospasm, and predicted the risk of symptomatic vasospasm, with an odds ratio of 1.42, while statin exposure was associated with a 2.75-fold increased risk of vasospasm, which may be related to abrupt statin withdrawal.
	www.psychiatrysource.com /psychsource/News/article1427.htm (379 words)

	Jefferson Neurosurgeons Use New Procedure To Reverse Dangerous Cerebral Vasospasm (Site not responding. Last check: 2007-10-29)
		Vasospasm is a narrowing of cerebral arteries several days after aneurysm rupture.
		The treatment currently is being evaluated as a preventive measure for ischemic stroke from vasospasm, with very encouraging initial results.
		About 30,000 people a year in North America are candidates for such a procedure to treat cerebral vasospasm, he says, and about 10-12 of every 100,000 worldwide.
	www.sciencedaily.com /releases/1998/10/981014073824.htm (722 words)

	Vasospasm of the nipple—a manifestation of Raynaud's phenomenon: case reports -- Lawlor-Smith and Lawlor-Smith 314 ...
		Vasospasm of the nipple—a manifestation of Raynaud's phenomenon: case reports -- Lawlor-Smith and Lawlor-Smith 314 (7081): 644 -- BMJ
		Vasospasm of the nipple–a manifestation of Raynaud's phenomenon: case reports
		Vasospasm of the nipple was described in 1970
	bmj.bmjjournals.com /cgi/content/full/314/7081/644 (570 words)

	Temporal Relationship Between Endothelin-1 Concentrations and Cerebral Vasospasm in Patients With Aneurysmal ...
		was due to vasospasm or to the primary hemorrhagic event.
		of angiographic vasospasm is in excess of 50%, with symptomatic
		Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning.
	stroke.ahajournals.org /cgi/content/full/32/5/1185 (4109 words)

	British Journal of Pharmacology - ET-1-associated vasomotion and vasospasm in lymphatic vessels of the guinea-pig ... (Site not responding. Last check: 2007-10-29)
		ET-1-associated vasomotion and vasospasm in lymphatic vessels of the guinea-pig mesentery
		ET-1, after being released from vascular endothelium, is known to act in a paracrine manner on ET and/or ET receptors on smooth muscles and ET receptors on the endothelium (Sokolovsky et al., 1992; Reeder and Ferguson, 1996; Ortega Mateo and de Artinano, 1997; Sakai et al., 1999).
		While vasospasm would be a less catastrophic event in lymphatic vessels, it remains a phenomenon of considerable interest, as the underlying mechanisms are likely to share the same properties as for blood vessels.
	www.nature.com /bjp/journal/v140/n8/full/0705573a.html (7828 words)

	Heme oxygenase-1 gene induction as an intrinsic regulation against delayed cerebral vasospasm in rats -- Suzuki et al. ...
		SAH induces angiographic vasospasm of the basilar artery.
		vasospasm was significantly attenuated (Figures 3a and 4).
		Hb and to decrease vasospasm due to extracellular Hb (15).
	www.jci.org /cgi/content/full/104/1/59 (5163 words)

	Transcranial Doppler Sonography Evaluation in Patients with Vasospasm following Subarachnoid Haemorrhage
		In the present series 12 patients suspected to have vasospasm after subarachnoid haemorrhage were confirmed and monitored with the help of TCD.
		It is noticed that vasospasm following subarachnoid haemorrhage has a typical course, which has increasing trend after 4th day of subarachnoid haemorrhage and declining trend after 14th day onwards.
		Six out of 12 patients were in moderate grade of vasospasm, 2 out of 12 were in severe grade and 4 out of 12 were mild grade of severity.
	www.pharma-lexicon.com /medicalnews.php?newsid=9180 (236 words)

	Coronary Vasospasm in Hypertrophic Cardiomyopathy -- Dimitrow et al. 119 (4): 1289 -- Chest
		Kodama, K, Shigematsu, Y, Hamada, M, et al (2000) The effect of coronary vasospasm on the direction of ST-segment deviation in patients with both hypertrophic cardiomyopathy and vasospastic angina.
		Hodgson, JM, Marshall, JJ (1989) Direct vasoconstriction and endothelium-dependent vasodilatation: mechanisms of acetylcholine effects on coronary flow and arterial diameter in patients with nonstenotic coronary arteries.
		Yasue, H, Matsuyama, K, Matsuyama, K, et al (1990) Responses of angiographically normal human coronary arteries to intracoronary injection of acetylcholine by age and segment: possible role of early coronary atherosclerosis.
	www.chestjournal.org /cgi/content/full/119/4/1289-a (1497 words)

	eMedicine - Coronary Artery Vasospasm : Article by Andrew P Selwyn, MD, MA, FACC, FRCP
		Pathophysiology: Prinzmetal angina is caused by focal coronary artery vasospasm, and a generalized abnormality of coronary artery vasomotor reactivity is not present.
		This may be an arbitrary distinction in some patients because it is likely that vasospasm is both a cause and a consequence of plaque rupture and thrombosis in patients with unstable angina pectoris, and many patients with variant angina have obstructive coronary artery disease.
		Ambulatory electrocardiography: Many episodes of coronary artery vasospasm are brief and may be asymptomatic; however, ST-segment changes may be detected by ambulatory electrocardiography and may better characterize the frequency and duration of myocardial ischemia.
	www.emedicine.com /med/topic447.htm (4882 words)

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