Controversies in the endovascular management of cerebral vasospasm after intracranial aneurysm rupture and future directions for therapeutic approaches

Neurosurgery. 2008 Apr;62(4):897-905; discussion 905-7. doi: 10.1227/01.neu.0000318175.05591.c3.


Cerebral vasospasm is one of the leading causes of morbidity and mortality after aneurysmal subarachnoid hemorrhage. Despite maximal medical therapy, however, up to 15% of patients surviving the ictus of subarachnoid hemorrhage experience stroke or death from vasospasm. For those cases of vasospasm that are refractory to medical treatment, endovascular techniques are frequently used, including balloon angioplasty with or without intra-arterial infusion of vasodilators, combined endovascular modalities, and aortic balloon devices. In this article, we review each of these therapies and their expanding role in the management of this condition. Moving forward, rigorous prospective outcome assessments after endovascular treatment of cerebral vasospasm are necessary to clearly delineate the efficacy and indications for these techniques.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aneurysm, Ruptured / complications*
  • Aneurysm, Ruptured / therapy*
  • Intracranial Aneurysm / complications*
  • Intracranial Aneurysm / therapy*
  • Practice Patterns, Physicians' / trends*
  • Rupture, Spontaneous / complications
  • Rupture, Spontaneous / therapy
  • Vasospasm, Intracranial / etiology*
  • Vasospasm, Intracranial / therapy*