Document Detail

Milrinone for the treatment of cerebral vasospasm after subarachnoid hemorrhage: report of seven cases.
MedLine Citation:
PMID:  11322432     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The intra-arterial infusion of papaverine has been used for dilation of spastic cerebral vessels after aneurysmal subarachnoid hemorrhage, although its efficacy is controversial. Milrinone is an inotropic drug that dilates vessels by phosphodiesterase inhibition in a mechanism similar to that of papaverine. We examined the effects of intra-arterial and subsequent intravenous administration of milrinone on patients with symptomatic cerebral vasospasm. METHODS: Seven patients with cerebral vasospasm were enrolled in this study. Milrinone was delivered intra-arterially via catheter at a rate of 0.25 mg/min. The total delivered dose was between 2.5 and 15 mg. Radiological measurement of the middle cerebral artery diameter and cerebral blood flow was carried out before and after arterial infusion. Intravenous treatment followed at 0.50 or 0.75 microg/kg/min for up to 2 weeks from the onset of subarachnoid hemorrhage. RESULTS: Dilation of the vasospastic vessels occurred in all patients. The rate of cerebral blood flow was calculated in six patients and was increased in all. Subsequent intravenous infusion was effective in preventing a recurrence of symptomatic vasospasm in four of the seven patients. CONCLUSION: It is suggested that milrinone was effective and safe for the treatment of cerebral vasospasm after subarachnoid hemorrhage in the patients in this series. Intra-arterial infusion with adjunctive intravenous infusion holds promise as a clinically advantageous treatment regimen.
Y Arakawa; K Kikuta; M Hojo; Y Goto; A Ishii; S Yamagata
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  48     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-26     Completed Date:  2001-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  723-8; discussion 728-30     Citation Subset:  IM    
Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
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MeSH Terms
Blood Flow Velocity / drug effects
Cerebral Angiography / drug effects
Dose-Response Relationship, Drug
Drug Administration Schedule
Infusions, Intra-Arterial
Infusions, Intravenous
Intracranial Aneurysm / drug therapy*
Middle Aged
Milrinone / administration & dosage*,  adverse effects
Subarachnoid Hemorrhage / drug therapy*
Vasodilation / drug effects
Vasospasm, Intracranial / drug therapy*
Reg. No./Substance:

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