On the Significance of Spasm Associated With Rupture of a Cerebral Aneurysm

Abstract

THE SIGNIFICANCE of spasm associated with rupture of a cerebral aneurysm has interested many workers. The etiology of the spasm remains obscure. The significance of the spasm in the etiology of infarction is debated. Stornelli and French 1 and Allcock and Drake 2 indicate that spasm has great prognostic significance. Crompton 3,4 and Schneck 5,6 indicate the importance of factors other than spasm in the pathogenesis of infarction. The angiographic evaluation of spasm is based on analysis of arterial phases of the angiographic study with the spasm being categorized as local or diffuse spasm. A further descriptive classification based on the severity of the spasm divided cases into three groups: grade 1 spasm, where the caliber of the vessel involved is narrowed by less than 50%; grade 2 spasm, where the vessel is narrowed by more than 50%; and grade 3 spasm, where the vessel is barely visible. Since