Early Angiographic Resolution of Cerebral Vasospasm with High Dose Intravenous Milrinone Therapy
Joint Authors
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-09-17
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Background.
Treatment of symptomatic delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is difficult.
Recent studies suggest intravenous (IV) high dose milrinone as a potential therapy.
The timing to angiographic response with this is unclear.
Methods.
We reviewed the chart of one patient admitted for SAH who developed symptomatic DCI and was treated with high dose IV milrinone.
Results.
A 66-year-old female was admitted with a Hunt and Hess clinical grade 4, World Federation of Neurological Surgeons (WFNS) clinical grade 4, and SAH secondary to a left anterior choroidal artery aneurysm which was clipped.
After bleed day 6, the patient developed symptomatic DCI.
We planned for angioplasty of the proximal segments.
We administered high dose IV milrinone bolus followed by continuous infusion which led to clinical improvement prior to angiography.
The angiogram performed 1.5 hours after milrinone administration displayed resolution of the CT angiogram and MRI based cerebral vasospasm such that further intra-arterial therapy was aborted.
She completed 6 days of continuous IV milrinone therapy, was transferred to the ward, and subsequently rehabilitated.
Conclusions.
High dose IV milrinone therapy for symptomatic DCI after SAH can lead to rapid neurological improvement with dramatic early angiographic improvement of cerebral vasospasm.
American Psychological Association (APA)
Zeiler, F. A.& Silvaggio, J.. 2015. Early Angiographic Resolution of Cerebral Vasospasm with High Dose Intravenous Milrinone Therapy. Case Reports in Critical Care،Vol. 2015, no. 2015, pp.1-5.
https://search.emarefa.net/detail/BIM-1058190
Modern Language Association (MLA)
Zeiler, F. A.& Silvaggio, J.. Early Angiographic Resolution of Cerebral Vasospasm with High Dose Intravenous Milrinone Therapy. Case Reports in Critical Care No. 2015 (2015), pp.1-5.
https://search.emarefa.net/detail/BIM-1058190
American Medical Association (AMA)
Zeiler, F. A.& Silvaggio, J.. Early Angiographic Resolution of Cerebral Vasospasm with High Dose Intravenous Milrinone Therapy. Case Reports in Critical Care. 2015. Vol. 2015, no. 2015, pp.1-5.
https://search.emarefa.net/detail/BIM-1058190
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1058190