実験的脳血管攣縮

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タイトル別名
  • Experimental Studies on Cerebral Vasospasm
  • 実験的脳血管攣縮--頭蓋底クモ膜下腔の持続洗浄の効果
  • ジッケンテキ ノウ ケッカン レンシュク トウガイ テイクモマクカ コウ ノ
  • Effect of Continuous Subarachnoid Irrigation
  • 頭蓋底クモ膜下腔の持続洗浄の効果

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Spasm of the major cerebral arteries occurs in more than 35 per cent of patients with subarachnoid hemorrhage due to the ruptured cerebral aneurysms, and the presence of severe spasm is known to affect greatly the prognosis of the patients. Despite extensive clinical and experimental investigations, no satisfactory treatment has been established up to the present.<BR>Experimental studies were performed to find out effective managements for cerebral arterial spasm. Cerebral vasospasm was produced experimentally by injection of autogenous fresh arterial blood into the cisterna magna of adult dogs and the effects of papaverine hydrochloride which was applied in various ways and concentrations, were evaluated.<BR>1. Biphasic cerebral vasospasm could be produced by injection of autogenous fresh arterial blood into the cisterna magna without vascular injuries and this model of experimental vasospasms was thought to be adequate for the present study.<BR>2. Papaverine hydrochloride was a potent vasodilating drug and its effect was found most marked when it was given directly into the cistern. However, duration of action was only transient.<BR>3. Continuous subarachnoid irrigation was found effective in reducing vasospasm. By adding a small amount of papaverine hydrochloride ( 2×10-3%), which gave far less concentration than those effectively used topically, to the perfusate the effect of relieving vasospasm was enhanced and prolonged spasmolytic effect was obtained.<BR>As a conclusion, it was important to reduce spasmogenic substances liberated from the blood clots in the subarachnoid space in order to get good and long-lasting effect in relieving vasospasm with spasmolytic agents such as papaverine, and continuous irrigation of the subarachnoid space was of value.

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