Prof. Dr. med. Werner Z'Graggen

Aneurysmal SAH with a special focus on diagnosis and treatment of cerebral vasospasm:

• Contrast enhanced ultrasound imaging for cerebral perfusion measurement in cerebral vasospasm after subarachnoid hemoraghe.
• Multimodal sonographic monitoring of cerebral perfusion, ventricle seize and optic nerve diameter during weaning of cerebrospinal fluid drainage catheters: a single center observational study.
• Individualized brain tissue oxygen monitoring probe placement helps to guide therapy and optimizes outcome in neurocritical care.
• Inhaled nitric oxide treatment for aneurysmal SAH patients with intractable cerebral vasospasm
• Conscious Sedation versus General Anesthesia during Endovascular Treatment of Cerebral Vasospasm.
• Crystalloid Fluid Choice and Neurological Outcome in Patients after Subarachnoid Haemorrhage – a multicenter randomized double-blind clinical trial (CrystallBrain).

Cerebral vasospasms and delayed cerebral ischemia still remain among the leading causes of morbidity and mortality in survivors of aneurysmal subarachnoid hemorrhage. Up to 40% of patients experience symptomatic cerebral vasospasms, resulting in disability in up to 50% thereof. (1) Cerebral vasospasms, a narrowing of cerebral arteries thought to be caused by blood breakdown products, mostly develop between 5 to 14 days after aneurysmal subarachnoid hemorrhage.  So far, there is no therapy known, which was shown in randomized trials to improve cerebral perfusion and thus to avoid brain ischemia and infarction in symptomatic patients. Our projects aim:

• To improve early diagnosis of evolving cerebral vasospasms by using new methods like contrast enhanced ultrasound imaging and individualized brain tissue oxygen monitoring probe placement.
• To improve treatment of symptomatic cerebral vasospasms by studying the effect of e.g. inhaled nitric oxide on vasospasms and the choice of anesthesia during endovascular treatment of cerebral vasospasm

Collaborations

Prof. Dr. J. Beck
Ärztlicher Direktor, Klinik für Neurochirurgie  
Breisacher Str. 64
79106 Freiburg
www.uniklinik-freiburg.de

PD Dr. med. Christian Fung
Oberarzt
Breisacher Str. 64
79106 Freiburg
www.uniklinik-freiburg.de