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Prostacyclin treatment normalises the MCA flow velocity in nimodipine-resistant cerebral vasospasm after aneurysmal subarachnoid haemorrhage: a pilot study
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
2009 (English)In: Acta Neurochir (Wien), Vol. 151, no 6, 595-9; discussion 599 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cerebral vasospasm triggered by subarachnoid haemorrhage is one of the major causes of post-haemorrhage morbidity and mortality. Several treatment modalities have been proposed, and none of them are fully effective. METHODS: In this study we treated five patients with prostacyclin suffering vasospasm after a ruptured aneurysm not responding to high i.v. doses of nimodipine. All patients were severely ill, unconscious and in need of intensive care. FINDINGS: A low dose of prostacyclin i.v. infusion for 72 h reversed the vasospasm as measured by transcranial Doppler technique. The mean MCA blood flow velocity decreased from 199 +/- 31 cm/s to 92 +/- 6 cm/s within 72 h after the start of the prostacyclin infusion. CONCLUSIONS: We suggest that low-dose prostacyclin treatment, an old treatment strategy, can be a treatment option in patients with vasospasm not responding to ordinary measures.

Place, publisher, year, edition, pages
2009. Vol. 151, no 6, 595-9; discussion 599 p.
Keyword [en]
Adult, Antihypertensive Agents/administration & dosage, Calcium Channel Blockers/administration & dosage, Cerebral Arteries/drug effects/physiopathology/ultrasonography, Cerebrovascular Circulation/drug effects/physiology, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Resistance/physiology, Epoprostenol/*administration & dosage, Female, Humans, Infarction, Middle Cerebral Artery/*drug therapy/etiology/*physiopathology, Male, Middle Aged, Nimodipine/administration & dosage, Pilot Projects, Prospective Studies, Subarachnoid Hemorrhage/*complications, Treatment Outcome, Ultrasonography, Doppler, Transcranial, Vasospasm, Intracranial/*drug therapy/etiology/*physiopathology
Identifiers
URN: urn:nbn:se:umu:diva-31398ISBN: 0942-0940 (Electronic) 0001-6268 (Linking) OAI: oai:DiVA.org:umu-31398DiVA: diva2:292948
Note
Koskinen, Lars-Owe D Olivecrona, Magnus Rodling-Wahlstrom, Marie Naredi, Silvana Research Support, Non-U.S. Gov't Austria Acta neurochirurgica Acta Neurochir (Wien). 2009 Jun;151(6):595-9; discussion 599. Epub 2009 Apr 7.Available from: 2010-02-10 Created: 2010-02-10 Last updated: 2010-06-03

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