Using of transcranial Doppler sonography to guide triple-H therapy in cerebral vasospasm associated with subarachnoid hemorrhage
نویسندگان
چکیده
Prophylactic triple-H therapy (the combination of induced hypertension, hypervolemia, and hemodilution) has been suggested to prevent cerebral vasospasm after subarachnoid hemorrhage (SAH) that would cause increased cerebral blood flow (CBF) to the brain, and widely accepted in a number of institutions. It must be noted that triple-H therapy is not completely safe, sometimes carries significant medical morbidity. The measurement of CBF with transcranial Doppler sonography (TCD) has provided a way of early detecting vasospasm after SAH as soon as possible and could guide the timing of triple-H therapy. Here, we present two patients who developed vasospasm associated with Aneurysmal SAH. In both patients, TCD examinations were daily performed to detect vasospasm before the onset of its clinical effects. One patient underwent mild vasospasm, resolved only by the treatment of triple-H therapy. While the second, followed-up triple-H therapy, suffered from vasodilator administered by intraarterial injecting for its severe vasospasm. In conclusion, our cases suggest that TCD optimize the timing of triple-H therapy in cerebral vasospasm associated with SAH.
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