{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:07:51Z","timestamp":1776096471209,"version":"3.50.1"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,3,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The optimal treatment for cerebral vasospasm (CV) following traumatic brain injury (TBI) has not been established, and management generally follows strategies developed for aneurysmal subarachnoid hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors report a case of a patient with traumatic subarachnoid hemorrhage and cerebral contusion who presented with worsening consciousness and disorientation and subsequently developed symptomatic CV on day 6 of hospitalization. MRI and 3D CT demonstrated narrowing of the left internal carotid artery and middle cerebral artery (MCA) with reduced cerebral perfusion. Intra-arterial administration of fasudil hydrochloride yielded a temporary improvement. However, MCA stenosis recurred the next day, requiring percutaneous transluminal balloon angioplasty. Subsequent imaging showed improved cerebral perfusion, and the patient was discharged without delayed cerebral ischemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Fluctuations in consciousness or neuropsychological symptoms after TBI should prompt evaluation for CV using perfusion imaging, even in the absence of focal neurological deficits. When a high risk of severe vasospasm accompanied by perfusion reduction is identified, prompt, stepwise therapeutic intervention should be implemented, beginning with the least invasive treatment option to optimize clinical outcomes.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/abs\/10.3171\/CASE25943\">https:\/\/thejns.org\/doi\/abs\/10.3171\/CASE25943<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25943","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:13:06Z","timestamp":1773925986000},"source":"Crossref","is-referenced-by-count":0,"title":["Endovascular treatment for symptomatic vasospasm following traumatic brain injury: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Risa","family":"Kubota","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Chiba, Japan"},{"name":"Chiba Cerebral and Cardiovascular Center, Ichihara-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4101-1633","authenticated-orcid":true,"given":"Shigeki","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9160-945X","authenticated-orcid":true,"given":"Masaaki","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6224-819X","authenticated-orcid":true,"given":"Yosuke","family":"Tajima","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9575-6246","authenticated-orcid":true,"given":"Kyoko","family":"Aoyagi","sequence":"additional","affiliation":[{"name":"Chiba Cerebral and Cardiovascular Center, Ichihara-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4400-3006","authenticated-orcid":true,"given":"Kentaro","family":"Horiguchi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba-City, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"World Neurosurg","first-page":"45","article-title":"Interventional treatment of symptomatic vasospasm in the setting of traumatic brain injury: a systematic review of reported cases","volume":"183","author":"Sorrentino","year":"2024","unstructured":"Sorrentino ZALucke-Wold BPLaurent DQuintin SSHoh BL.Interventional treatment of symptomatic vasospasm in the setting of traumatic brain injury: a systematic review of reported cases. 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No Shinkei Geka. 2005;33(2):133-140."},{"issue":"12","key":"bib25","series-title":"Jpn J Neurosurg","first-page":"777","article-title":"Endovascular treatment of cerebral vasospasm","volume":"11","author":"Hyogo","year":"2002","unstructured":"Hyogo T.Endovascular treatment of cerebral vasospasm. Article in Japanese. Jpn J Neurosurg. 2002;11(12):777-782. doi:10.7887\/jcns.11.777"},{"key":"bib1","series-title":"World Neurosurg","first-page":"45","article-title":"Interventional treatment of symptomatic vasospasm in the setting of traumatic brain injury: a systematic review of reported cases","volume":"183","author":"Sorrentino","year":"2024","unstructured":"Sorrentino ZALucke-Wold BPLaurent DQuintin SSHoh BL.Interventional treatment of symptomatic vasospasm in the setting of traumatic brain injury: a systematic review of reported cases. 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