The dilemma of cerebral vasospasm treatment.

Abstract

Symptomatic cerebral vasospasm following subarachnoid hemorrhage from ruptured saccular aneurysms is a major factor in the neurologic deterioration of these patients. Many therapeutic interventions have been proposed to treat this cerebral vasospasm; however, the most effective means to counteract this development still eludes the health care team. Faced with this dilemma, recent investigators have examined subarachnoid blood as visualized on CT scan. These studies have enabled them to identify those patients most at risk for developing symptomatic cerebral vasospasm. Predicting the occurrence as well as the severity and location of symptomatic cerebral vasospasm will facilitate early implementation of preventative measures. This knowledge may help to minimize the frequent unfavorable outcomes following subarachnoid hemorrhage and the subsequent development of vasospasm. The neuroscience nurse can apply this information to the clinical setting by being able to identify those patients at high risk for developing symptomatic cerebral vasospasm, to improve assessment skills, and to plan and anticipate the patient's future needs. A case study is offered to illustrate how this is accomplished.