What is a normal Lindegaard ratio?
Normal = MFV <120 cm/s, Lindegaard Ratio <3.
How do you measure vasospasm?
Various modalities are present for evaluation and detection of cerebral vasospasm that occurs following SAH. They include transcranial Doppler (TCD), computed tomographic angiography (CTA), computed tomographic (CT) perfusion and digital subtraction angiography (DSA).
What is the gold standard for diagnosing cerebral vasospasm?
Angiography of the vessels of the brain is the gold standard for the diagnosis of cerebral vasospasm. However, this procedure is invasive, requires the availability of significant resources, and may cause vessel dissection or thrombosis.
How common is vasospasm?
Vasospasm is the most common complication of SAH and is the main cause of delayed morbidity and mortality. It usually occurs 4 to 14 days after the initial accident, with a peak incidence at 7 days. Its rate of occurrence varies according to the authors from 40 to 70% 38. It is symptomatic in 17 to 40% of cases 10.
How do you prevent vasospasm after subarachnoid hemorrhage?
Nimodipine has been recommended as first-line medical treatment for preventing post-aSAH cerebral vasospasm. It is usually given orally at a dosage of 60 mg every 4 hours for 21 days after the initial subarachnoid hemorrhage.
Why is circle of Willis important?
The circle of Willis plays an important role, as it allows for proper blood flow from the arteries to both the front and back hemispheres of the brain. The arteries that stem off from the circle of Willis supply much of the blood to the brain.
Does nimodipine reduce vasospasm?
Some experts have proposed the scheme of 30 mg oral nimodipine every 2 h is more conducive to alleviate vasospasm, especially for the patients with low blood pressure [11]. But its efficiency and safety is needed to be evaluated.
Does nimodipine prevent vasospasm?
Nimodipine is a dihydropyridine that blocks calcium influx through the L-type calcium channels. It is the most rigorously studied and only drug approved by the US Food and Drug Administration for use in treatment of vasospasm.
How can I reduce vasospasm?
Maintenance of euvolemia and normal circulating blood volume is recommended to prevent vasospasm. In symptomatic vasospasm, induction of hypertension is recommended to achieve increased cerebral blood flow. Hypervolemia is no longer recommended as a measure to prevent vasospasm.