Haitham Dababneh1, Waldo Guerrero2, Siddhart Mehta3, Mohammad Moussavi3, Jawad F Kirmani3. 1. Contributed equally to this work. 2. University of Texas Health Science Center, Houston, TX 77030, USA ; Contributed equally to this work. 3. Stroke & Neurovascular Center at JFK Neuroscience Institute, Edison, NJ 08818, USA.
Abstract
OBJECTIVE: Approximately 18,000 patients suffer from a subarachnoid hemorrhage (SAH) in the United States annually. SAH is a form of stroke and comprises 1%-5% of all strokes. Nearly 50% of all SAH cases end in fatality within 30 days of presentation; one of eight patients die before reaching a hospital. Those who survive often have neurological or cognitive impairment. METHODS: This case report describes the course of two patients who presented to the emergency department with aneurismal subarachnoid hemorrhage and received external ventricular drainage and endovascular treatment of their aneurysm. RESULTS: Both patients required treatment with Eptifibatide drip after endovascular approach and their SAH in the basal cisterns resolved by day 5. Neither patient developed signs of clinical or subclinical vasospasm. COMMENTS: Eptifibatide drip facilitated resolution of the thick clot in the subarachnoid space early enough to eliminate the direct toxicity of oxyhemoglobin on the cerebral arteries and arachnoid granulations, thus preventing vasospasm and eliminating the necessity for a long-term shunt.
OBJECTIVE: Approximately 18,000 patients suffer from a subarachnoid hemorrhage (SAH) in the United States annually. SAH is a form of stroke and comprises 1%-5% of all strokes. Nearly 50% of all SAH cases end in fatality within 30 days of presentation; one of eight patients die before reaching a hospital. Those who survive often have neurological or cognitive impairment. METHODS: This case report describes the course of two patients who presented to the emergency department with aneurismal subarachnoid hemorrhage and received external ventricular drainage and endovascular treatment of their aneurysm. RESULTS: Both patients required treatment with Eptifibatide drip after endovascular approach and their SAH in the basal cisterns resolved by day 5. Neither patient developed signs of clinical or subclinical vasospasm. COMMENTS: Eptifibatide drip facilitated resolution of the thick clot in the subarachnoid space early enough to eliminate the direct toxicity of oxyhemoglobin on the cerebral arteries and arachnoid granulations, thus preventing vasospasm and eliminating the necessity for a long-term shunt.
Authors: Muhammad Zeeshan Memon; Sabareesh K Natarajan; Jitendra Sharma; Marlon S Mathews; Kenneth V Snyder; Adnan H Siddiqui; L Nelson Hopkins; Elad I Levy Journal: J Neurosurg Date: 2010-09-24 Impact factor: 5.115
Authors: A I Qureshi; Z Ali; M F Suri; S H Kim; R D Fessler; A J Ringer; L R Guterman; L N Hopkins Journal: Neurosurgery Date: 2001-05 Impact factor: 4.654