Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

One of the complications of cerebral arterial aneurysm is cerebral vasospasm which can occur in the presence or in the absence of cerebral aneurysm rupture and subarachnoid hemorrhage (SAH). Cerebral vasospasm is a serious complication as it causes luminal narrowing of large cerebral arteries after SAH, which leads to decreased cerebral blood flow (CBF) and ischemia in the affected vascular territories. Vessel narrowing typically begins 3-5 days after initial hemorrhage, with peak vasoconstriction occurring between days 5 and 14. Vasospasm occurs due to several cascades of complex events in the affected blood vessels and neurons, which can be divided into three main categories: elevated levels of intracellular calcium (Ca2+), increased production of vasoactive substances, and structural injury to arterial vessel walls

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