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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 1999 March;65(3):115-24

language: Italian

Subarachnoid hemorrhage and systemic arterial pressure. Pathophysiology and perioperative management

De Vivo P., Ciritella P., Del Gaudio A., Marzano T. F., Mastronardi P.

Ospedale «Casa Sollievo della Sofferenza», Istituto di Ricovero e Cura a Carattere Scientifico, S. Giovanni Rotondo (Foggia), II Servizio di Anestesia e Rianimazione;
Università degli Studi di Napoli «Federico II» - Napoli, Istituto di Anestesia e Rianimazione e Terapia Intensiva;
Cattedra di Anestesia Generale e Speciale Odontostomatologica


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A correct assessment of arterial pressure state during subarachnoid haemorrhage (SAH) is one of most critical issue in neurologic intensive care and in neuroanesthesia. It is important to evaluate two different clinical conditions during SAH: before and after aneurysmal clipping or embolization. Before clipping it is mandatory to evaluate a possibility of rebleeding and so it is important to mantain systolic pressure at lower level. Otherwise after clipping it can be useful to mantein systolic pressure at higher level to prevent vasospasm and related ischemia. In this review the Authors examine the pathophysiology of SAH and SAH complications as rebleeding, vasospasm and ischemia. According to international data, they propose pressure parameters appropriated for SAH according to timing of treatment so as to prevent and treat SAH complications.

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