Hypertensive encephalopathy as a complication of hyperdynamic therapy for vasospasm: report of two cases
| Autor: | Sumeer Sathi, Sepideh Amin-Hanjani, Philip E. Stieg, Richard B. Schwartz |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
Hypertensive encephalopathy Subarachnoid hemorrhage Encephalopathy Iatrogenic Disease Blood Pressure Cerebral vasospasm Fatal Outcome Dobutamine medicine Humans cardiovascular diseases Nimodipine Aged Brain Diseases business.industry Vasospasm Middle Aged medicine.disease nervous system diseases Hydrocephalus Blood pressure Ischemic Attack Transient Anesthesia Hypertension Surgery Female Neurology (clinical) business Tomography X-Ray Computed medicine.drug |
| Zdroj: | Neurosurgery. 44(5) |
| ISSN: | 0148-396X |
| Popis: | OBJECTIVE AND IMPORTANCE: After developing subarachnoid hemorrhage, patients may deteriorate from a variety of well-known causes, including rebleeding, hydrocephalus, and vasospasm. Many patients now undergo empirical hyperdynamic vasospasm therapy with hypervolemia, induced hypertension, and nimodipine. CLINICAL PRESENTATION: We report two cases of iatrogenic hypertensive encephalopathy occurring during hyperdynamic therapy for cerebral vasospasm after subarachnoid hemorrhage. Hypertensive encephalopathy is a syndrome of rapidly evolving generalized or focal cerebral symptoms occurring in the setting of severe hypertension, which is reversible with antihypertensive therapy. INTERVENTION: The syndrome can be diagnosed in the appropriate clinical setting with computed tomographic or magnetic resonance imaging that demonstrates characteristic findings. In both cases, decreasing the blood pressure resulted in neurological improvement. CONCLUSION: In the setting of induced hypertensive/hypervolemic therapy for vasospasm, hypertensive encephalopathy should be considered as a potentially reversible cause of delayed neurological decline. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|