Postoperative hypertension in the management of patients with intracranial arterial aneurysms

Edward J. Kosnik Department of Surgery, Division of Neurological Surgery, Ohio State University College of Medicine, Columbus, Ohio

Search for other papers by Edward J. Kosnik in
Current site
Google Scholar
PubMed
Close
 M.D.
and
William E. Hunt Department of Surgery, Division of Neurological Surgery, Ohio State University College of Medicine, Columbus, Ohio

Search for other papers by William E. Hunt in
Current site
Google Scholar
PubMed
Close
 M.D.
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $536.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $636.00
USD  $45.00
USD  $536.00
USD  $636.00
Print or Print + Online Sign in

✓ Elevation of systemic arterial pressure in seven patients with intracranial arterial aneurysms has been shown to be effective in alleviating ischemic symptoms attributed to cerebral vasospasm. Autoregulation is at least partially lost in patients with cerebral hemodynamic crisis. Blood volume expansion was used to augment vasopressors in maintenance of systemic hypertension. The management of these cases is discussed. Caution in the use of this technique is advised, since the regimen is not without risk.

  • Collapse
  • Expand
  • 1.

    Alksne JF: Myonecrosis in chronic experimental vasospasm. Surgery 76:17, 1974 Alksne JF: Myonecrosis in chronic experimental vasospasm. Surgery 76:1–7, 1974

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Allen GS, , Henderson LM, & Chou SN, et al: Cerebral arterial vasospasm, Part 1: In vitro contractile activity of vasoactive agents on canine basilar and middle cerebral arteries. J Neurosurg 40:433441, 1974 Allen GS, Henderson LM, Chou SN, et al: Cerebral arterial vasospasm, Part 1: In vitro contractile activity of vasoactive agents on canine basilar and middle cerebral arteries. J Neurosurg 40:433–441, 1974

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Allen GS, , Henderson LM, & Chou SN, et al: Cerebral arterial spasm, Part 2: In vitro contractile activity of serotonin in human serum and CSF on the canine basilar artery, and its blockage by methylsergide and phenoxybenzamine. J Neurosurg 40:442450, 1974 Allen GS, Henderson LM, Chou SN, et al: Cerebral arterial spasm, Part 2: In vitro contractile activity of serotonin in human serum and CSF on the canine basilar artery, and its blockage by methylsergide and phenoxybenzamine. J Neurosurg 40:442–450, 1974

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Brawley BW, , Strandness DE Jr, & Kelley WA: The biphasic response of cerebral vasospasm in experimental subarachnoid hemorrhage. J Neurosurg 28:18, 1968 Brawley BW, Strandness DE Jr, Kelley WA: The biphasic response of cerebral vasospasm in experimental subarachnoid hemorrhage. J Neurosurg 28:1–8, 1968

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Denny-Brown D: The treatment of recurrent cerebrovascular symptoms and the question of “vasospasm.” Med Clin North Am 35:14571474, 1951 Denny-Brown D: The treatment of recurrent cerebrovascular symptoms and the question of “vasospasm.” Med Clin North Am 35: 1457–1474, 1951

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Farhat SM, & Schneider RC: Observations on the effect of systemic blood pressure on intracranial circulation in patients with cerebrovascular insufficiency. J Neurosurg 27:441445, 1967 Farhat SM, Schneider RC: Observations on the effect of systemic blood pressure on intracranial circulation in patients with cerebrovascular insufficiency. J Neurosurg 27: 441–445, 1967

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Flamm ES, , Kim J, & Lin J, et al: Phosphodiesterase inhibitors and cerebral vasospasm. Trans Am Neurol Assoc 99:137140, 1974 Flamm ES, Kim J, Lin J, et al: Phosphodiesterase inhibitors and cerebral vasospasm. Trans Am Neurol Assoc 99:137–140, 1974

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Hunt WE, & Kosnik EJ: Timing and perioperative care in intracranial aneurysm surgery. Clin Neurosurg 21:7989, 1974 Hunt WE, Kosnik EJ: Timing and perioperative care in intracranial aneurysm surgery. Clin Neurosurg 21:79–89, 1974

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Kapp JP, , Mahaley MS Jr, & Odom GL: Experimental evaluation of potential spasmolytic drugs. J Neurosurg 32:468472, 1970 Kapp JP, Mahaley MS Jr, Odom GL: Experimental evaluation of potential spasmolytic drugs. J Neurosurg 32:468–472, 1970

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Kim J, , Flamm ES, & Lin J: Experimental cerebral vasospasm and cyclic adenosine monophosphate. Invest Radiol (In press) Kim J, Flamm ES, Lin J: Experimental cerebral vasospasm and cyclic adenosine monophosphate. Invest Radiol (In press)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    King BD, , Sokoloff L, & Wechsler RL: The effects of l-epinephrine and l-norepinephrine upon cerebral circulation and metabolism in man. J Clin Invest 31:273279, 1952 King BD, Sokoloff L, Wechsler RL: The effects of l-epinephrine and l-norepinephrine upon cerebral circulation and metabolism in man. J Clin Invest 31:273–279, 1952

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Lassen NA: Autoregulation of cerebral blood flow. Circ Res (Suppl) 1:201203, 1974 Lassen NA: Autoregulation of cerebral blood flow. Circ Res (Suppl) 1:201–203, 1974

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Lende RA: Local spasm in cerebral arteries. J Neurosurg 17:90103, 1960 Lende RA: Local spasm in cerebral arteries. J Neurosurg 17:90–103, 1960

  • 14.

    Meyerson SB, , Hall JL, & Hunt WE: Intramural neural elements in components of the carotid bifurcation. A histological basis for different function. J Neurosurg 34:209221, 1971 Meyerson SB, Hall JL, Hunt WE: Intramural neural elements in components of the carotid bifurcation. A histological basis for different function. J Neurosurg 34:209–221, 1971

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Miller CA, , Yashon D, & Locke G, et al: Autonomous activity in the human basilar artery: relationship to cerebral vascular spasm. Neurology 21:12491254, 1971 Miller CA, Yashon D, Locke G, et al: Autonomous activity in the human basilar artery: relationship to cerebral vascular spasm. Neurology 21:1249–1254, 1971

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Nagai H, , Noda S, & Mabe H: Experimental cerebral vasospasm, Part 2: Effects of vasoactive drugs and sympathectomy on early and late spasm. J Neurosurg 42:420428, 1975 Nagai H, Noda S, Mabe H: Experimental cerebral vasospasm, Part 2: Effects of vasoactive drugs and sympathectomy on early and late spasm. J Neurosurg 42:420–428, 1975

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Nagai H, , Suzuki Y, & Sugiura M, et al: Experimental cerebral vasospasm, Part 1: Factors contributing to early spasm. J Neurosurg 41:285292, 1974 Nagai H, Suzuki Y, Sugiura M, et al: Experimental cerebral vasospasm, Part 1: Factors contributing to early spasm. J Neurosurg 41:285–292, 1974

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Pennink M, , White RP, & Crockarell JR, et al: Role of prostaglandin F in the genesis of experimental cerebral vasospasm. Angiographic study in dogs. J Neurosurg 37:398406, 1972 Pennink M, White RP, Crockarell JR, et al: Role of prostaglandin F in the genesis of experimental cerebral vasospasm. Angiographic study in dogs. J Neurosurg 37:398–406, 1972

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Peterson EW, , Searle R, & Mandy FF, et al: The reversal of experimental vasospasm by dibutyryl-3′, 5′-adenosine onophosphate. J Neurosurg 39:730734, 1973 Peterson EW, Searle R, Mandy FF, et al: The reversal of experimental vasospasm by dibutyryl-3′, 5′-adenosine onophosphate. J Neurosurg 39:730–734, 1973

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Rosenblum EI: Microscopic observations of pial artery constriction induced by local BaCl2 and its inhibition by other topically applied agents. Bibl Anat 7:8185, 1965 Rosenblum EI: Microscopic observations of pial artery constriction induced by local BaCl2 and its inhibition by other topically applied agents. Bibl Anat 7:81–85, 1965

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Shanbrom E, & Levy L: The role of systemic blood pressure in cerebral circulation in carotid and basilar artery thromboses. Clinical observations and therapeutic implications of vasopressor agents. Am J Med 23:197204, 1957 Shanbrom E, Levy L: The role of systemic blood pressure in cerebral circulation in carotid and basilar artery thromboses. Clinical observations and therapeutic implications of vasopressor agents. Am J Med 23:197–204, 1957

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Smigiel MR Jr, & Sundt TM Jr: Comparative effectiveness of alpha-blockade and betastimulation in modifying experimental basilar arterial spasm. J Neurosurg 41:300305, 1974 Smigiel MR Jr, Sundt TM Jr: Comparative effectiveness of alpha-blockade and betastimulation in modifying experimental basilar arterial spasm. J Neurosurg 41:300–305, 1974

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Symon L: Personal communication, October 11, 1975 Symon L: Personal communication, October 11, 1975

    • PubMed
    • Export Citation
  • 24.

    Waltz AG: Effect of blood pressure on blood flow in ischemic and in nonischemic cerebral cortex. The phenomena of autoregulation and luxury perfusion. Neurology 18:613621, 1968 Waltz AG: Effect of blood pressure on blood flow in ischemic and in nonischemic cerebral cortex. The phenomena of autoregulation and luxury perfusion. Neurology 18:613–621, 1968

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Wernick S, & Sugar O: Treatment of postangiographic hemiplegia with vasopressors. J Neurosurg 41:755757, 1974 Wernick S, Sugar O: Treatment of postangiographic hemiplegia with vasopressors. J Neurosurg 41:755–757, 1974

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Wilkins RH: Attempts at treatment of intracranial arterial spasm in animals and human beings. Surg Neurol 1:148159, 1973 Wilkins RH: Attempts at treatment of intracranial arterial spasm in animals and human beings. Surg Neurol 1:148–159, 1973

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Wilkins RH, , Alexander JA, & Odom GL: Intracranial arterial spasm: a clinical analysis. J Neurosurg 29:121134, 1968 Wilkins RH, Alexander JA, Odom GL: Intracranial arterial spasm: a clinical analysis. J Neurosurg 29:121–134, 1968

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Wise G, , Sutter R, & Burkholder J: The treatment of brain ischemia with vasopressor drugs. Stroke 3:135142, 1972 Wise G, Sutter R, Burkholder J: The treatment of brain ischemia with vasopressor drugs. Stroke 3:135–142, 1972

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Yashon D, , Dunker RO Jr, & Locke GE, et al: Comparison of in vitro reactivity of cerebral and somatic arteries. Neurology 20:398, 1970 (Abstract NA-11) Yashon D, Dunker RO Jr, Locke GE, et al: Comparison of in vitro reactivity of cerebral and somatic arteries. Neurology 20:398, 1970 (Abstract NA-11)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Yashon D, , Dunker RO Jr, & Locke GE, et al: In vitro basilar and common carotid artery reactivity to alpha and beta stimulation. Neurology 21:10851087, 1971 Yashon D, Dunker RO Jr, Locke GE, et al: In vitro basilar and common carotid artery reactivity to alpha and beta stimulation. Neurology 21:1085–1087, 1971

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 1595 186 53
Full Text Views 661 23 1
PDF Downloads 192 14 2
EPUB Downloads 0 0 0