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Intra-arterial infusion of high-dose papaverine for cerebral vasospasm

  • S. Yoshimura
  • N. Hashimoto
  • T. Tsukahara
  • K. Kazekawa
  • K. Sampei
  • S. Nishi
  • T. Iwama
  • Y. Gotoh
Conference paper

Abstract

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 words

Cerebral vasospasm Papaverine Subarachnoid haemorrhage 

References

  1. 1.
    Kaku Y, Yonekawa Y, Tsukahara T (1992) Superselective intraarterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage. J Neurosurg 77:842–847.PubMedCrossRefGoogle Scholar
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    Yoshimura S, Hashimoto N, Tsukahara T (1993) Treatment of cerebral vasospasm after subarachnoid hemorrhage with high-dose nicardipine and intra-arterial papaverine. In Findlay JM (ed) Cerebral vasospasm, vol 8. Elevier, Amsterdam, pp 365–368.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • S. Yoshimura
    • 1
  • N. Hashimoto
    • 1
  • T. Tsukahara
    • 1
  • K. Kazekawa
    • 1
  • K. Sampei
    • 1
  • S. Nishi
    • 1
  • T. Iwama
    • 1
  • Y. Gotoh
    • 1
  1. 1.Department of NeurosurgeryNational Cardiovascular CenterSuita, OsakaJapan

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