Effect of hyperdynamic therapy on cerebral ischaemia caused by vasospasm associated with subarachnoid haemorrhage

Summary Ten patients who developed neurological deficits associated with angiographically proven cerebral vasospasm caused by ruptured aneurysm were treated with hyperdynamic therapy induced by administration of a large amount of human serum albumin. No vaso-active drugs were administered. Cardiopulmonary function and intracranial pressure were monitored during the treatment. Marked improvement of neurological function was observed in all cases. Nine patients recovered completely without any neurological residual following treatment. The degree of the improvement observed during treatment closely correlated with the decrease in total peripheral resistance. Infusion of albumin did not cause elevation of intracranial pressure. It was concluded that the hyperdynamic therapy induced by administration of albumin has a dramatic effect on the ischaemic cerebral insult caused by vasospasm. It is postulated that the main effect of this treatment is produced by cerebrovascular dilatation.