{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:26:31Z","timestamp":1772112391551,"version":"3.50.1"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1990,2]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 The effect of clot removal on cerebral vasospasm was studied in 104 patients with aneurysmal subarachnoid hemorrhage (SAH). The series included patients who fulfilled all of the following criteria: operation was performed by Day 3 after the ictus; the patient's preoperative clinical grade was between Grades I and IV; there was no rebleeding; computerized tomography (CT) showed only SAH; and carotid angiograms were performed by Day 2 and repeated between Days 7 and 9. Both the degree of SAH on CT and angiographic vasospasm were graded from 0 to III. The relationship of the SAH grade in the basal frontal interhemispheric fissure (IHF) to the presence of vasospasm at the A<jats:sub>2<\/jats:sub> segments of the anterior cerebral artery and the relationship of the SAH grade in the sylvian stems to the presence of vasospasm at the M<jats:sub>1<\/jats:sub> segments of the middle cerebral artery were analyzed.<\/jats:p>\n<jats:p content-type=\"fine-print\">Correlation of preoperative and postoperative SAH grades with the angiographic vasospasm grades, with the incidence of symptomatic vasospasm, and with the low-density area on CT could be found in the A<jats:sub>2<\/jats:sub> and M<jats:sub>1<\/jats:sub> territories. Decrease of cisternal blood measured by CT after the operation did not relate directly to the reduction of vasospasm. When the SAH was Grade II or III in the basal frontal IHF, the angiographic vasospasm grades at the A<jats:sub>2<\/jats:sub> were significantly lower in patients with surgery via the interhemispheric approach than in those with surgery via the pterional approach. Symptomatic vasospasm occurred in two of the eight cases operated on by the interhemispheric approach compared with 11 of the 22 cases approached via the pterional route. In patients with a pterional approach, there was no significant difference in severity of vasospasm in the M<jats:sub>1<\/jats:sub> territory between the side of approach and the opposite side. No consistent relationship could be found between the time interval from SAH to operation and the severity of vasospasm. While clot removal may ameliorate cerebral vasospasm, its effect <jats:italic>per se<\/jats:italic> does not seem to be significant.<\/jats:p>","DOI":"10.3171\/jns.1990.72.2.0224","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T18:20:46Z","timestamp":1242238846000},"page":"224-230","source":"Crossref","is-referenced-by-count":74,"title":["Effect of clot removal on cerebral vasospasm"],"prefix":"10.3171","volume":"72","author":[{"given":"Tetsuji","family":"Inagawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuo","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuko","family":"Kamiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"949","DOI":"10.3171\/jns.1985.63.6.0949","article-title":"Delayed CSF lavage for arteriographic and morphological vasospasm after experimental SAH.","volume":"63","author":"Alexander","year":"1985"},{"key":"b2","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1227\/00006123-198407000-00011","article-title":"Acute operation and preventive nimodipine improve outcome in patients with ruptured cerebral aneurysms.","volume":"15","author":"Auer","year":"1984"},{"key":"b3","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1227\/00006123-198001000-00001","article-title":"Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning.","volume":"6","author":"Fisher","year":"1980"},{"key":"b4","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1227\/00006123-197711000-00004","article-title":"Cerebral vasospasm with ruptured saccular aneurysm \u2014 the clinical manifestations.","volume":"1","author":"Fisher","year":"1977"},{"key":"b5","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1227\/00006123-198510000-00013","article-title":"Computed tomographic grading with Hounsfield number related to delayed vasospasm in cases of ruptured cerebral aneurysm.","volume":"17","author":"Fujita","year":"1985"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"558","DOI":"10.3171\/jns.1987.67.4.0558","article-title":"The effect of timing of clot removal on chronic vasospasm in a primate model.","volume":"67","author":"Handa","year":"1987"},{"key":"b7","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/BF01728866","article-title":"Surgery in the prevasospastic interval.","volume":"63","author":"Hashi","year":"1982"},{"key":"b8","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"14","DOI":"10.3171\/jns.1968.28.1.0014","article-title":"Surgical risk as related to time of intervention in the repair of intracranial aneurysms.","volume":"28","author":"Hunt","year":"1968"},{"key":"b9","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"332","DOI":"10.3171\/jns.1988.69.3.0332","article-title":"Management of elderly patients with aneurysmal subarachnoid hemorrhage.","volume":"69","author":"Inagawa","year":"1988"},{"key":"b10","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/BF01809552","article-title":"Enhanced cisternal drainage and cerebral vasospasm in early aneurysm surgery.","volume":"80","author":"Ito","year":"1986"},{"key":"b11","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/BF01728859","article-title":"The microsurgical anterior interhemispheric approach suitably applied to ruptured aneurysms of the anterior communicating artery in the acute stage.","volume":"63","author":"Ito","year":"1982"},{"key":"b12","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1161\/01.STR.16.4.562","article-title":"Cerebral vasospasm following aneurysmal subarachnoid hemorrhage.","volume":"16","author":"Kassell","year":"1985"},{"key":"b13","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1227\/00006123-198701000-00003","article-title":"Cisternal drainage after early operation of ruptured intracranial aneurysm.","volume":"20","author":"Kawakami","year":"1987"},{"key":"b14","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1227\/00006123-198203000-00001","article-title":"Prevention of vasospasm by early operation with removal of subarachnoid blood.","volume":"10","author":"Mizukami","year":"1982"},{"key":"b15","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1227\/00006123-198012000-00008","article-title":"Value of computed tomography in the prediction of cerebral vasospasm after aneurysm rupture.","volume":"7","author":"Mizukami","year":"1980"},{"key":"b16","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1136\/jnnp.47.11.1197","article-title":"Prediction of delayed cerebral ischemia after subarachnoid hemorrhage by computed tomography.","volume":"47","author":"Mohsen","year":"1984"},{"key":"b17","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"416","DOI":"10.3171\/jns.1987.66.3.0416","article-title":"Effect of clot removal at 24 hours on chronic vasospasm after SAH in the primate model.","volume":"66","author":"Nosko","year":"1987"},{"key":"b18","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1227\/00006123-198409000-00009","article-title":"Role of computed tomography in the management of vasospasm after subarachnoid hemorrhage.","volume":"15","author":"Pasqualin","year":"1984"},{"key":"b19","series-title":"Neurol Med Chir","doi-asserted-by":"publisher","first-page":"103","DOI":"10.2176\/nmc.19.103","article-title":"Vasospasm following rupture of cerebral aneurysms.","volume":"19","author":"Saito","year":"1979"},{"key":"b20","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"412","DOI":"10.3171\/jns.1977.47.3.0412","article-title":"Significance of vasospasm in the treatment of ruptured intracranial aneurysms.","volume":"47","author":"Saito","year":"1977"},{"key":"b21","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1227\/00006123-198602000-00005","article-title":"Delayed ischemic deterioration in patients with early aneurysm operation and intravenous nimodipine.","volume":"18","author":"S\u00e4veland","year":"1986"},{"key":"b22","series-title":"Neurol Med Chir","first-page":"83","article-title":"Early operations for ruptured intracranial aneurysms \u2014 study of 31 cases operated on within the first four days after ruptured aneurysms.","volume":"18","author":"Suzuki","year":"1978"},{"key":"b23","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"622","DOI":"10.3171\/jns.1982.57.5.0622","article-title":"Effect of early operation for ruptured aneurysms on prevention of delayed ischemic symptoms.","volume":"57","author":"Taneda","year":"1982"},{"key":"b24","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"440","DOI":"10.3171\/jns.1983.58.3.0440","article-title":"Biphasic occurrence of delayed ischemia after early aneurysm surgery. Case report.","volume":"58","author":"Taneda","year":"1983"},{"key":"b25","series-title":"Psychiatr Neurol Neurochir","first-page":"411","article-title":"Clinical aspects of subarachnoid hemorrhage and significance of vasospasm.","volume":"75","author":"Van der Werf","year":"1972"},{"key":"b26","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1016\/0090-3019(84)90268-4","article-title":"Removal of subarachnoid blood clots after subarachnoid hemorrhage.","volume":"21","author":"Wakabayashi","year":"1984"},{"key":"b27","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1227\/00006123-198606000-00026","article-title":"Attempts at prevention or treatment of intracranial arterial spasm: an update.","volume":"18","author":"Wilkins","year":"1986"},{"key":"b28","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"121","DOI":"10.3171\/jns.1968.29.2.0121","article-title":"Intracranial arterial spasm: a clinical analysis.","volume":"29","author":"Wilkins","year":"1968"},{"key":"b29","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1227\/00006123-198302000-00006","article-title":"Early operation for ruptured intracranial aneurysms: comparative study with computed tomography.","volume":"12","author":"Yamamoto","year":"1983"},{"key":"b30","series-title":"Surg Neurol","first-page":"7","article-title":"The microsurgical approach to intracranial aneurysms.","volume":"3","author":"Ya\u015fargil","year":"1975"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/72\/2\/article-p224.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/72\/2\/article-p224.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/72\/2\/article-p224.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T22:13:26Z","timestamp":1679868806000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/72\/2\/article-p224.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,2]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1990.72.2.0224","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1990,2]]}}}