A brain aneurysm rupture is one of the more grave neurosurgical emergencies.
Part of the problem is that even after the initial ruptured aneurysm and its bleeding are dealt with, later complications can strike after the patient is seemingly out of the woods.
One of these complications is known as a cerebral vasospasm. Dr. E. Sander Connolly, who runs the Cerebrovascular Research Laboratory here at Columbia University Medical Center/New York Presbyterian Hospital, wants to solve the problem of cerebral vasospasm.
Here is what is known about the problem so far: For reasons that are unclear, roughly a week after a rupture, blood vessels in the brain can suddenly clamp closed. With the blood vessels squeezed tight, blood does not reach part of the brain, leading to a stroke. On top of the damage caused by the initial rupture and bleeding, this can cause disability or even death.
According to Dr. Connolly, neurosurgeons must be mindful of the threat of this complication, in addition to treating the initial aneurysm rupture. A big challenge is that there seems to be no one standard of care for preventing these cerebral vasospasms.
A recent study, co-authored by Dr. Connolly, confirms this lack of consistent treatment among various neurosurgical practices across the country. While all neurosurgeons agree on the need for prevention of cerebral vasospasm, there is no agreement on how exactly this should be done.
One approach to cerebral vasospasm is intra-arterial therapy. Here, medication is administered directly into the brain using catheters guided through the patient’s blood vessels. According to Dr. Connolly’s research, many, but not all, neurosurgeons agree on this approach.
“By delivering the medicine so close to the problem, intra-arterial therapies can have favorable outcomes for patients,” Dr. Connolly says. “But as this study shows, further research would be beneficial in guiding care.”
Dr. Connolly’s march to find the answers will continue on.
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