Failure of intracisternal tissue plasminogen activator to prevent vasospasm in certain patients with aneurysmal subarachnoid hemorrhage.

摘要: Recent experimental and clinical reports suggest that the intracisternal administration of recombinant tissue plasminogen activator (tPA) within 72 hours subarachnoid hemorrhage decreases incidence severe angiographic vasospasm. In this report, we present four eight patients with aneurysmal who developed vasospasm delayed neurological deterioration, despite use tPA after early aneurysm clipping. One patient did not clear her massive tPA; one had extremely poor collateral flow occlusion cervical internal carotid artery 80% stenosis other artery; two a 7 to 12 days their sentinel hemorrhage. Three ultimately made excellent or good recoveries, was left hemiparesis. The treated by protocol develop We conclude may prevent in certain patients. This relate inadequate clearing clot, pre-existing supply, occurrence prior