What are the symptoms of cerebral vasospasm

As current conditions improve, more and more people are suffering from cerebrovascular diseases. For the sake of health, some people will undergo physical examinations every year to check whether their cardiovascular and cerebrovascular systems are healthy. Angiography is currently the most direct way to check cardiovascular and cerebrovascular diseases. Some people will find that their blood vessels are in spasm during the examination, but they do not have any symptoms and are as normal as ordinary people. Some patients only go for examinations after certain symptoms appear. So, what are the symptoms of cerebral vasospasm?

Cerebral vasospasm refers to a persistent constriction of the intracranial arteries. If the blood vessels are found to be in a spasm state only during angiography and the patient has no corresponding symptoms of neurological deficits, it is called asymptomatic vasospasm; if the patient has symptoms of neurological deficits, it is called symptomatic vasospasm, also known as delayed ischemic neurological dysfunction. Cerebral vasospasm is one of the most common complications of aneurysmal subarachnoid hemorrhage.

Causes

Rupture of intracranial aneurysm often leads to subarachnoid hemorrhage. The blood and its degradation products flowing into the subarachnoid space are the main causes of cerebral vasospasm. Craniocerebral injury, craniocerebral surgery, intravascular interventional treatment, tuberculous and purulent meningitis, migraine, hypertensive encephalopathy, etc. can also induce cerebral vasospasm.

Clinical manifestations

Cerebral vasospasm itself has no typical specific clinical manifestations. Generally, 3 to 5 days after subarachnoid hemorrhage, if there is a deterioration in consciousness, even accompanied by new focal localization signs, such as hemiplegia, hemisensory disturbance, aphasia, and manifestations of increased intracranial pressure, such as headache and vomiting, the possibility of cerebral vasospasm should be highly suspected after clinical exclusion of electrolyte disorders and CT examination excludes secondary hydrocephalus and intracranial hematoma. Unexplained fever and increased white blood cell count may also lead to the possibility of cerebral vasospasm.

prevention

The following prevention and treatment of cerebral vasospasm is mainly aimed at cerebral vasospasm caused by aneurysmal subarachnoid hemorrhage. Other types of cerebral vasospasm can be used as a reference and treated as appropriate according to the patient's actual situation. It includes etiological treatment, prevention as the main approach, full course of treatment, and prevention and treatment of complications.

1. Imaging examinations suggest cerebral vasospasm. Patients have clinical symptoms and require early treatment and dynamic monitoring.

2. If the patient has cerebral vasospasm but has no clinical symptoms, preventive treatment and dynamic monitoring are recommended.

3. Even if cerebral vasospasm is not found, patients with clinical symptoms still need treatment and dynamic monitoring.

4. For patients with high-risk factors for cerebral vasospasm, such as spontaneous aneurysmal subarachnoid hemorrhage, subarachnoid hemorrhage due to craniocerebral injury, and after surgery around large blood vessels, even if the patients have no clinical symptoms, they still need to strengthen disease monitoring and give preventive treatment.

In short, early diagnosis and early adoption of effective prevention and treatment measures are the key links to reduce the occurrence of cerebral vasospasm and improve prognosis.