PREVENCIJA I TRETMAN CEREBRALNOG VAZOSPAZMA NAKON ANEURIZMALNE SUBARAHNOIDALNE HEMORAGIJE – PREGLEDNI ČLANAK

  • Valentina D Opančina Fakultet medicinskih nauka, Univerzitet u Kragujevcu
Ključne reči: cerebral vasospasm||, ||cerebralni vazospazam, subarachnoid hemorrhage||, ||subaranhodialno krvarenje, aneurysms||, ||aneurizme, treatment||, ||tretman, prevention||, ||prevancija,

Sažetak


Uvod. Cerebralni vazospazam je najozbiljnija komplikacija subarahnoidalnog krvarenja. Može se definisati kao odloženo i samo-ograničavajuće stanje čija je težina povezana sa zapreminom, gustinom, produženim prisustvo, i lokacijom subarahnoidalne krvi. Oko 70% ovih pacijenata pokazuje angiografske dokaze vazospazma, a oko 50% njih ima neurološke deficite. Cilj ovog članka je pregled novijeg napretka i buduće perspektive u prevenciji i lečenju cerebralnog vazospazma nakon aneurizmalnog subarahnoidalnog krvarenja.
Materijali i metode. Izvršeno je opsežno pretraživanje literature u Medline i Ebsko bazama podataka. Izabrani su originalni radovi, meta-analize i pregledni članci iz poslednjih 10 godina, sa pristupačnim punim-tekstovima, na engleskom jeziku.
Prevencija i lečenje. Glavna medicinska strategija za prevenciju vazospazma obuhvata održavanje normalnog volumena cirkulišuće krvi i terapiju oralnim Nimodipinom. Trenutno, jedina utvrđena terapija za lečenje cerebralnog vazospazma je euvolemički indukovana hipertenzija. Perkutana transluminalna angioplastika i / ili selektivna intra-arterijska vasodilatatorna terapija su razumne u pacijenata sa simptomatskim cerebralnim vazospazmom, naročito kod onih koji ne reaguju brzo na hipertenzivnu terapiju.
Zaključak. Novi pristupi koji se aktivno razvijaju i puno obećavaju u lečenju vazospazma u narednim godinama obuhvataju imunomodulatore, anestetike, hipotermiju, akupunkturu, neuroprotektivna sredstva i multimodalne režima lečenja.

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2016/11/28
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