Hypertensive Encephalopathy as a Complication of Hyperdynamic Therapy for Vasospasm: Report of Two Cases
作者:
Sepideh,
Amin-Hanjani Richard,
Schwartz Sumeer,
Sathi Philip,
期刊:
Neurosurgery
(OVID Available online 1999)
卷期:
Volume 44,
issue 5
页码: 1113-1116
ISSN:0148-396X
年代: 1999
出版商: OVID
关键词: Hyperdynamic therapy;Hypertensive encephalopathy;Magnetic resonance imaging;Subarachnoid hemorrhage;Vasospasm
数据来源: OVID
摘要:
OBJECTIVE AND IMPORTANCE:After developing subarachanoid hemorrhage, patients may deteriorate from a variety of well-known causes, including rebleeding, hydrocephalus, and vasospasm. Many patients now undergo empirical hyperdynamic vasospasm therapy with hypervolemia, induced hypertension, and nimodipine.CLINICAL PRESENTATION:We report two cases of iatrogenic hypertensive encephalopathy occurring during hyperdynamic therapy for cerebral vasospasm after subarachnoid hemorrhage. Hypertensive encephalopathy is a syndrome of rapidly evolving generalized or focal cerebral symptoms occurring in the setting of severe hypertension, which is reversible with antihypertensive therapy.INTERVENTION:The syndrome can be diagnosed in the appropriate clinical setting with computed tomographic or magnetic resonance imaging that demonstrates characteristics findings. In both cases, decreasing the blood pressure resulted in neurological improvement.CONCLUSION:In the setting of induced hypertensive/hypervolemic therapy for vasospasm, hypertensive encephalopathy should be considered as a potentially reversible cause of delayed neurological decline.
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