| Reversal of radiographically impending stroke with multiple intraarterial papaverine infusions in severe diffuse cerebral vasospasm induced by subarachnoid hemorrhage. | |
| | |
MedLine Citation:
|
PMID: 11810389 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Selective intraarterial infusion of papaverine is used in the treatment of symptomatic cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage (SAH). Delays in instituting therapy for vasospasm can lead to irreversible cerebral infarction and a devastating outcome. Endovascular papaverine treatment of vasospasm in the presence of low-attenuation lesions on computed tomography (CT) is controversial, because of the fear of reperfusion hemorrhage in completed infarcts. METHOD: Two patients with aneurysmal SAH who subsequently developed severe diffuse vasospasm were identified. In both patients, large areas of low-attenuation change suggesting impending cerebral infarction were seen on CT scans. The patients received multiple infusions of intraarterial papaverine in an effort to treat vasospasm refractory to medical management. FINDINGS: After multiple intermittent administrations of papaverine, which initially appeared to increase the low-attenuation changes, there was dramatic reversal of the radiographic findings. There was also improvement in circulation time, transcranial Doppler velocities, and clinical outcome. INTERPRETATION: These findings suggest that in some patients, intraarterial infusions of papaverine initiated in the earliest stages of ischemia may exacerbate the radiographic appearance of low-attenuation changes, but may ultimately reverse the evolution of cerebral infarction. |
| | |
Authors:
|
J K Liu; M S Tenner; H M Oestreich; W T Couldwell |
Related Documents
:
|
3973149 - Ct demonstration of calcification within old cerebral infarcts. 19553909 - Noninvasive assessment of the brain redox status after transient middle cerebral artery... 13677569 - Neuroimaging in spasticity and movement disorders. 22024289 - The clinical evaluation of bone tumors. 12669159 - Serial mri in a case of familial hemiplegic migraine. 3336899 - Evolving focal cerebral ischemia in cats: spatial correlation of nuclear magnetic reson... 22055999 - Morphological-metabolic evaluation of the urachal mucinous adenocarcinoma by positron e... 1551509 - Value of ct and sonography in the conservative management of acute splenoportal and sup... 10841059 - Lipoma arborescens: high-resolution ultrasonographic findings. |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Acta neurochirurgica Volume: 143 ISSN: 0001-6268 ISO Abbreviation: Acta Neurochir (Wien) Publication Date: 2001 Dec |
Date Detail:
|
Created Date: 2002-01-25 Completed Date: 2002-02-20 Revised Date: 2009-11-11 |
Medline Journal Info:
|
Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: Austria |
Other Details:
|
Languages: eng Pagination: 1249-55; discussion 1256 Citation Subset: IM |
Affiliation:
|
Department of Neurosurgery, New York Medical College, Valhalla, New York 10595, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Brain Ischemia / drug therapy, etiology* Female Humans Infusions, Intra-Arterial Male Papaverine / administration & dosage, pharmacology* Stroke / etiology, prevention & control* Subarachnoid Hemorrhage / complications* Tomography, X-Ray Computed Vasodilator Agents / administration & dosage, pharmacology* Vasospasm, Intracranial / complications, drug therapy*, pathology |
| Chemical | |
Reg. No./Substance:
|
0/Vasodilator Agents; 58-74-2/Papaverine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A new method and software for quantitative analysis of continuous intracranial pressure recordings.
Next Document: Value of transcranial Doppler ultrasonography in the diagnosis and follow-up of carotid-cavernous fi...