About this Journal Submit a Manuscript Table of Contents
Neurology Research International
Volume 2013 (2013), Article ID 256713, 6 pages
http://dx.doi.org/10.1155/2013/256713
Review Article

Evidence-Based Cerebral Vasospasm Surveillance

Vanderbilt University Medical Center, Department of Neurological Surgery, T-4224 Medical Center North, Nashville, TN 37212, USA

Received 24 November 2012; Accepted 20 May 2013

Academic Editor: William J. Mack

Copyright © 2013 Heather Kistka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Subarachnoid hemorrhage related to aneurysmal rupture (aSAH) carries significant morbidity and mortality, and its treatment is focused on preventing secondary injury. The most common—and devastating—complication is delayed cerebral ischemia resulting from vasospasm. In this paper, the authors review the various surveillance technologies available to detect cerebral vasospasm in the days following aSAH. First, evidence related to the most common modalities, including transcranial doppler ultrasonography and computed tomography, are reviewed. Continuous electroencephalography and older instruments such as positron emission tomography, xenon-enhanced CT, and single-photon emission computed tomography are also discussed. Invasive strategies including brain tissue oxygen monitoring, microdialysis, thermal diffusion, and jugular bulb oximetry are examined. Lastly, near-infrared spectroscopy, a recent addition to the field, is briefly reviewed. Each surveillance tool carries its own set of advantages and limitations, and the concomitant use of multiple modalities serves to improve diagnostic sensitivity and specificity.