Article Text
Statistics from Altmetric.com
A 29 year old man was referred to our department from a local hospital in November 2000, for treatment of acute subarachnoid haemorrhage. At examination, he presented with stupor and a Glasgow coma scale score of 7 and was intubated and artificially ventilated. Diagnostic angiography was performed the same day and demonstrated a ruptured arterior cerebral artery aneurysm. The complex configuration of the aneurysm precluded embolisation as a treatment option. Surgery was performed the next day and the aneurysm was successfully clipped. After surgery, the patient received the calcium channel blocker nimodipine intravenously at a dosage of 2 mg/hour and moderate hypervolaemic haemodilution using isotonic solutions to prevent vasospasm induced brain ischaemia. Transcranial Doppler flow velocities were less than 140 cm/s from day 1 to 5 postoperatively. At day 6, Transcranial Doppler flow values increased up to 200 cm/s indicating severe cerebral vasospasm. Cerebral angiography was performed demonstrating 80% vasospasm on the left internal carotid artery (C1 segment). …