Prostacyclin treatment normalises the MCA flow velocity in nimodipine-resistant cerebral vasospasm after aneurysmal subarachnoid haemorrhage: a pilot study
2009 (English)In: Acta Neurochir (Wien), Vol. 151, no 6, 595-9; discussion 599 p.Article in journal (Refereed) Published
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.
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
IdentifiersURN: urn:nbn:se:umu:diva-31398ISBN: 0942-0940 (Electronic) 0001-6268 (Linking)OAI: oai:DiVA.org:umu-31398DiVA: diva2:292948
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 7.2010-02-102010-02-102010-06-03