Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage pathogenesis

The phenomenon of delayed cerebral ischemia (DCI) is yet not fully understood and the correlation of angiographic vasospasm and cerebral infarction is still unclear.

Little is known about the role of epigenetics in DCI pathogenesis.

Platelet activation has been postulated to be involved in the pathogenesis of delayed cerebral ischemia (DCI) and cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH).

Delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

It is a rare complication following epilepsy surgery.

Dickerson et al., from the Department of Neurosurgery, University of Mississippi Medical Center, Jackson, USA report the third known case and first of diffuse vasospasm. A 48-year-old woman underwent a transcortical anterior left temporal lobectomy. Eleven days later, she had new-onset expressive aphasia with narrowing of the anterior, middle, and posterior cerebral arteries, and increased velocities via transcranial Doppler. She was treated with fluids, nimodipine, and permissive hypertension. At 6 months, her speech was near baseline. Cerebral vasospasm may represent a rare cause of morbidity after anterior temporal lobectomy; a literature review on the subject is presented ¹⁾.