Intra-arterial infusion of high-dose papaverine for cerebral vasospasm
We treated 14 patients with cerebral vasospasm with intra-arterial infusion of high-dose papaverine without balloon angioplasty. When cerebral vasospasm was diagnosed on angiography after confirmation of absence of major infarct on CT, superselective infusion of papaverine was performed. High-dose (80–120 mg) of papaverine was infused in the M1 or A1 segment, or a higher dose (160–320 mg) of papaverine was infused at the top of the internal carotid artery. Of the 14 patients treated by this method, 12 improved angiographically and clincally; 2, treated more than 6 h after the onset of neurological deficits, did not improve. Temporary neurological deficits during infusion appeared in 2 of 14 cases but disappeared within 30 min after infusion. A small haemorrhage without clinical manifestation was recognised in 1 case on the follow-up CT. Infusion of high-dose papaverine is considered to be safe and effective and it should be performed without delay.
Key wordsCerebral vasospasm Papaverine Subarachnoid haemorrhage
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