Why does cerebral vasospasm occur

Fraser, MD References: Goldman. Philadelphia: PA. Bradley, Neurology in Clinical Practice, 5th ed. This resource has been developed by Idorsia Pharmaceuticals Ltd in order to provide an environment to deliver a better understanding of aSAH and cerebral vasospasm and to pool information regarding the condition, the diagnosis procedure, available treatments and the impact it can have on the lives of those affected.

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About this eBook This eBook has been developed by Idorsia Pharmaceuticals Ltd as a resource to improve understanding of cerebral vasospasm occurring after aneurysmal subarachnoid hemorrhage. The book is intended for the use of a general audience.

Understanding aSAH and cerebral vasospasm. What is aSAH? Unlike other types of brain hemorrhage, which can be caused by severe head injuries, aSAH is specifically caused by the rupture of an aneurysm — a weak, bulging spot on the wall of a brain artery — which allows blood to escape and accumulate in the space around the brain.

Any bleeding on the brain is very dangerous as the blood pools together and places pressure on the surrounding brain tissue. This, coupled with the interrupted blood supply due to the burst blood vessel, reduces much-needed blood flow to the brain and can cause severe damage.

What is cerebral vasospasm and what causes it? Endothelin is one of the most powerful, long-acting vasoactive mediators that causes blood vessels to contract. Patients with cerebral vasospasm show high levels of endothelin in their cerebral spinal fluid. Greater understanding of the role that endothelin may play in causing cerebral vasospasm has led to new treatments that block its negative effect being researched as a potential way to prevent or reverse vasospasm in the future.

How common is cerebral vasospasm and who gets it? What is the outlook for people with aSAH and cerebral vasospasm? Where does aSAH occur in the brain? Vasospasm occurs when a brain blood vessel narrows, blocking blood flow. It can occur in the two weeks following a subarachnoid hemorrhage or brain aneurysm. You are at greater risk for a cerebral vasospasm if you have had a recent subarachnoid hemorrhage or ruptured brain aneurysm. However, there are ways to prevent or minimize each type of vasospasm.

For vasospasm in small arteries and arterioles, avoiding triggers is the most important treatment. Most people have a good outlook if they avoid things that trigger a vasospasm and follow their recommended treatment plan.

However, early treatment of an SAH decreases the risk that complications like vasospasms will occur. A type of medication, called nitrates, is used to prevent coronary vasospasms. Cholesterol-lowering medications called statins may also prevent them. In addition, avoiding things that trigger spasms can help prevent them. Triggers include:. Wearing gloves and warm socks in the cold can help prevent symptoms. Avoiding triggers is also helpful.

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