Abstract
Introduction: Posttraumatic vasospasm (PTV) is a relatively common event following traumatic brain injury (TBI) that has been strongly correlated with worse neurological outcome in many studies. However, vasospasm continues to be an under-recognized source of secondary injury following TBI, and currently published guidelines do not address screening or management strategies for PTV. Brain tissue oxygen (PbtO2) monitoring probes allow for continuous screening for cerebral hypoxia following TBI, but their use as a monitor for PTV has not been previously described. Methods: Case report and literature review. Results: We present a case of PTV identified by persistent low PbtO2 despite aggressive medical therapy. Computed tomography and digital subtraction angiography confirmed severe cerebral arterial vasospasm involving both anterior and posterior circulations. The patient was successfully treated with serial intraarterial therapy including balloon angioplasty and verapamil infusion. Conclusion: Posttraumatic vasospasm should be included in the differential diagnosis of cerebral hypoxia (e.g., low PbtO2) following TBI. Management strategies for PTV may include early, aggressive intraarterial therapies including drug infusion and balloon angioplasty.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 61-69 |
| Number of pages | 9 |
| Journal | Neurocritical Care |
| Volume | 10 |
| Issue number | 1 |
| DOIs | |
| State | Published - Feb 2009 |
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Keywords
- Angioplasty
- Brain tissue oxygen
- PO
- Traumatic brain injury
- Vasospasm
- Verapamil
ASJC Scopus subject areas
- Clinical Neurology
- Critical Care and Intensive Care Medicine
Cite this
Posttraumatic vasospasm detected by continuous brain tissue oxygen monitoring : Treatment with intraarterial verapamil and balloon angioplasty. / Shahlaie, Kiarash; Boggan, James E; Latchaw, Richard E; Ji, Cheng; Muizelaar, Jan Paul.
In: Neurocritical Care, Vol. 10, No. 1, 02.2009, p. 61-69.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Posttraumatic vasospasm detected by continuous brain tissue oxygen monitoring
T2 - Treatment with intraarterial verapamil and balloon angioplasty
AU - Shahlaie, Kiarash
AU - Boggan, James E
AU - Latchaw, Richard E
AU - Ji, Cheng
AU - Muizelaar, Jan Paul
PY - 2009/2
Y1 - 2009/2
N2 - Introduction: Posttraumatic vasospasm (PTV) is a relatively common event following traumatic brain injury (TBI) that has been strongly correlated with worse neurological outcome in many studies. However, vasospasm continues to be an under-recognized source of secondary injury following TBI, and currently published guidelines do not address screening or management strategies for PTV. Brain tissue oxygen (PbtO2) monitoring probes allow for continuous screening for cerebral hypoxia following TBI, but their use as a monitor for PTV has not been previously described. Methods: Case report and literature review. Results: We present a case of PTV identified by persistent low PbtO2 despite aggressive medical therapy. Computed tomography and digital subtraction angiography confirmed severe cerebral arterial vasospasm involving both anterior and posterior circulations. The patient was successfully treated with serial intraarterial therapy including balloon angioplasty and verapamil infusion. Conclusion: Posttraumatic vasospasm should be included in the differential diagnosis of cerebral hypoxia (e.g., low PbtO2) following TBI. Management strategies for PTV may include early, aggressive intraarterial therapies including drug infusion and balloon angioplasty.
AB - Introduction: Posttraumatic vasospasm (PTV) is a relatively common event following traumatic brain injury (TBI) that has been strongly correlated with worse neurological outcome in many studies. However, vasospasm continues to be an under-recognized source of secondary injury following TBI, and currently published guidelines do not address screening or management strategies for PTV. Brain tissue oxygen (PbtO2) monitoring probes allow for continuous screening for cerebral hypoxia following TBI, but their use as a monitor for PTV has not been previously described. Methods: Case report and literature review. Results: We present a case of PTV identified by persistent low PbtO2 despite aggressive medical therapy. Computed tomography and digital subtraction angiography confirmed severe cerebral arterial vasospasm involving both anterior and posterior circulations. The patient was successfully treated with serial intraarterial therapy including balloon angioplasty and verapamil infusion. Conclusion: Posttraumatic vasospasm should be included in the differential diagnosis of cerebral hypoxia (e.g., low PbtO2) following TBI. Management strategies for PTV may include early, aggressive intraarterial therapies including drug infusion and balloon angioplasty.
KW - Angioplasty
KW - Brain tissue oxygen
KW - PO
KW - Traumatic brain injury
KW - Vasospasm
KW - Verapamil
UR - http://www.scopus.com/inward/record.url?scp=63249107134&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=63249107134&partnerID=8YFLogxK
U2 - 10.1007/s12028-008-9138-z
DO - 10.1007/s12028-008-9138-z
M3 - Article
C2 - 18807219
AN - SCOPUS:63249107134
VL - 10
SP - 61
EP - 69
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 1
ER -