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Intra-arterial Administration of Verapamil for the Prevention and Treatment of Cerebral Angiospasm

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Subarachnoid Hemorrhage

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 127))

Abstract

From 2013 to 2017, at the Burdenko Institute of Neurosurgery, intra-arterial verapamil for treatment of cerebral vasospasm following intracranial hemorrhage after aneurysm rupture was administered to 35 patients (total 75 procedures). The age is from 8 to 77 years. All ruptured aneurysms were treated: in 26 cases with open approach—clipping—and in 9 cases with endovascular occlusion. The procedure was carried out from 0 to 11 days after the operation. Severity of spasm was assessed by angiography and TCDU. Efficacy of the administration was assessed by TCDU 1 h after the procedure and by clinical evaluation of the patient’s condition. The dose of verapamil was 15–50 mg (on average 40 mg) per procedure/per carotid pool and depended on the data of TCDU and clinical and radiological picture. The procedure was performed repeatedly (1–5 times) according to the indications and depending on the patient’s condition, with an interval of 24 h. The procedure was effective as a preventive measure for care of patients in the initial stage of cerebral ischemia and was ineffective with a formed focus of ischemia. Endovascular administration of verapamil for treatment of cerebral vasospasm is a safe technique which positively affects the overall recovery of such patients.

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Conflict of Interest

The authors declare that they have no conflict of interests.

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Authors and Affiliations

  1. Burdenko Institute of Neurosurgery, Moscow, Russia

    K. G. Mikeladze, D. N. Okishev, O. B. Belousova, A. N. Konovalov, Yu. V. Pilipenko, I. S. Ageev, A. N. Kaftanov, O. D. Shekhtman, N. V. Kurdyumova, T. F. Tabasaransky, E. A. Okisheva, S. S. Eliava & S. B. Yakovlev

Authors
  1. K. G. Mikeladze
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  2. D. N. Okishev
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  3. O. B. Belousova
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  4. A. N. Konovalov
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  5. Yu. V. Pilipenko
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  6. I. S. Ageev
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  7. A. N. Kaftanov
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  8. O. D. Shekhtman
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  9. N. V. Kurdyumova
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  10. T. F. Tabasaransky
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  11. E. A. Okisheva
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  12. S. S. Eliava
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  13. S. B. Yakovlev
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Editor information

Editors and Affiliations

  1. Department of Anethesiology, Loma Linda University Medical Center, Loma Linda, CA, USA

    Robert D. Martin

  2. Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, CA, USA

    Warren Boling

  3. Department of Neurosurgery, First Affiliated Hospital of Soochow University, Suzhou, China

    Gang Chen

  4. Department of Anesthesiology and Physiology, Loma Linda University Medical Center, Loma Linda, CA, USA

    John H. Zhang

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Mikeladze, K.G. et al. (2020). Intra-arterial Administration of Verapamil for the Prevention and Treatment of Cerebral Angiospasm. In: Martin, R., Boling, W., Chen, G., Zhang, J. (eds) Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 127. Springer, Cham. https://doi.org/10.1007/978-3-030-04615-6_28

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  • DOI: https://doi.org/10.1007/978-3-030-04615-6_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04614-9

  • Online ISBN: 978-3-030-04615-6

  • eBook Packages: MedicineMedicine (R0)

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