A Pilot Study of Facial Nerve Stimulation on Cerebral Artery Vasospasm in Subarachnoid Hemorrhage Patients

October 9, 2019

Daniel San-JuanMarco A. ZentenoDania TrinidadFranklin MezaMark K. BorsodyMaria De Monserrat Godinez GarciaFernando Castro PradoEmilio Sarcistan

Early Access Note:
Early Access articles are new content made available in advance of the final electronic or print versions and result from IEEE’s Preprint or Rapid Post processes. Preprint articles are peer-reviewed but not fully edited. Rapid Post articles are peer-reviewed and edited but not paginated. Both these types of Early Access articles are fully citable from the moment they appear in IEEE Xplore.

Background: The objective of this pilot study was to assess the safety and efficacy of VitalFlow stimulation in aSAH patients with vasospasm for the purpose of guiding the design of larger, controlled studies in vasospasm patients, a largely untreated condition [1]. Methods: Six patients with angiographic vasospasm developing post-aSAH were treated with VitalFlow stimulation. Digital subtraction angiograms were obtained at the time of diagnosis (baseline) and then 30 minutes post-stimulation. A single 2-minute period of stimulation was delivered to the patients using parameters previously shown to be safe, tolerable, and effective at increasing CBF in healthy volunteers. Results: VitalFlow stimulation improved tissue perfusion as assessed by parenchymography and reversed the constriction of vasospastic arteries. Two patients had only partial improvement and so were treated with intraarterial nimodipine after VitalFlow stimulation, whereas four patients had complete resolution of the vasospasm after VitalFlow stimulation per the treating neuroendovascular surgeon’s evaluation. Clinical examination showed improvement in Hunt and Hess Scale scores assessed post-stimulation. Conclusions: Non-invasive magnetic stimulation of the facial nerve with the VitalFlow stimulator appears to be a safe and effective means to reverse angiographic vasospasm in aSAH patients. Clinical Impact: This study provides Class IV evidence that non-invasive magnetic stimulation of the facial nerve reduces angiographic measures of vasospasm in aSAH patients.

READ FULL ARTICLE ON IEEE XPLORE

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