Effect of Antiplatelet Agent, Ca Blocking Agent, and Hypervolemic Therapy on Prevention of the Symptomatic Vasospasm after Subarachnoid Hemorrhage

DOI

Bibliographic Information

Other Title
  • 破裂脳動脈瘤症例に対する Ca<SUP>?</SUP> 抗剤, 抗血小板剤および hypervolemic therapy の有効性について
  • 特に Transcranial Doppler Ultrasonography による検討

Abstract

In the pathogenesis of symptomatic vasospasm after subarachnoid hemorrhage (SAH), hyperactivity of the platelet, hypercoagulable state and impairment of cerebral microcirculation are considered to play important roles. The authors assess the incidence and clinical course fo symptomatic vasospasm in 88 aneurysmal patients with a uniform management protocol of antiplatelet, Ca blocking agent, and hypervolemic therapy. All patients received an antiplatelet agent (Ticlopidine) and a Ca blocking agent (Nicardipine) after surgery was performed within 48 hours following SAH. The flow velocity of the middle cerebral artery (MCA. FV) was measured after surgery by transcranial Doppler sonography (TCD), and when MCA. FV exceeded 120 cm/sec within seven days after SAH, hypervolemic therapy was started with albumin and Hetastarch. Nine patients (10%) developed characteristic signs and symptoms of symptomatic vasospasm in spite of these managements, but major neurological deficits from vasospasm occurred only in three patients (3%). In the total series, 70 patients (80%) had a good outcome and only five patients (5.7%) died of cardiac, pulmonary complication or sepsis. There were no fatal complications attributable to the antiplatelet agent, Ca? blocking agent or hypervolemic therapy.<BR>This management strategy may lower the incidence of death and disability from vasospasm after SAH.

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Details 詳細情報について

  • CRID
    1390282680439930624
  • NII Article ID
    130004668157
  • DOI
    10.2335/scs1987.17.4_318
  • ISSN
    09145508
  • Text Lang
    ja
  • Data Source
    • JaLC
    • Crossref
    • CiNii Articles
  • Abstract License Flag
    Disallowed

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