Document Detail


Treatment of cerebral vasospasm with intra-arterial papaverine.
MedLine Citation:
PMID:  1432125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cerebral vasospasm continues to be the leading treatable cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage. In this preliminary anecdotal series of 12 patients who were candidates for balloon angioplasty, vasospasm was treated instead with intra-arterial papaverine. Eight patients had marked angiographic reversal of the arterial narrowing following papaverine infusion, four of whom showed dramatic reversal of profound neurological deficits. Two patients deteriorated clinically 5 days after the initially successful papaverine infusions. In both, repeat angiography demonstrated severe recurrent vasospasm, which was partially reversed with a second intra-arterial papaverine treatment. Two patients developed focal neurological deficits during papaverine infusion, which resolved spontaneously over several hours after cessation of the intra-arterial infusion. Arterial narrowing in the posterior circulation and middle cerebral artery distribution appeared to be more responsive to papaverine infusion than was spasm in the anterior cerebral arteries. The infusion of 300 mg of papaverine over 1 hour seemed to be an adequate and safe dose to effect these angiographic and clinical improvements.
Authors:
N F Kassell; G Helm; N Simmons; C D Phillips; W S Cail
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  77     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1992-12-17     Completed Date:  1992-12-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  848-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / complications
Female
Humans
Infusions, Intra-Arterial
Intracranial Aneurysm / complications
Ischemic Attack, Transient / drug therapy*,  etiology,  radiography
Male
Middle Aged
Papaverine / administration & dosage*,  adverse effects
Recurrence
Rupture, Spontaneous
Chemical
Reg. No./Substance:
58-74-2/Papaverine
Comments/Corrections
Comment In:
J Neurosurg. 1993 Nov;79(5):797-8   [PMID:  8410265 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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