Cerebral Protection With Barbiturates, Nizofenone and Steroids

  • Shinya Manaka
  • Takaaki Kirino
  • Mamoru Sasaki


Steroids and barbiturates have been considered to be very reasonable drugs for cerebral protection from ischemic or traumatic insult. However, controversies on the effectiveness of these drugs have been growing [1–3]. On one hand there are experimental studies which strongly support the utility of these drugs for cerebral trauma or ischemia, but recent clinical studies based on randomized well-controlled trials have failed to show any advantages for these drugs [4–8]. The initial clinical enthusiasm for the widespread application of barbiturates to protects the brain from head injury, circulatory arrest, asphyxia, or ischemia has almost disappeared. Clinical and experimental data showed that complete global ischemic injury has not been favorably altered by barbiturate coma therapy, while barbiturates do appear to protect the brain damage from focal or incomplete ischemia/hypoxia [2,3]. If barbiturates are given before permanent occlusion, the size of the ensuing infarct is significantly reduced [9]. Barbiturate protection from cerebral ischemia/hypoxia is, at least partially, the result of a depressed metabolic demand for oxygen. Astrup demonstrated that the metabolic depression resulted from inhibition of neurotransmission [10].


Head Injury Middle Cerebral Artery Occlusion Severe Head Injury Mongolian Gerbil Neuronal Density 
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Copyright information

© Springer-Verlag Tokyo 1991

Authors and Affiliations

  • Shinya Manaka
    • 1
  • Takaaki Kirino
    • 2
  • Mamoru Sasaki
    • 3
  1. 1.Department of NeurosurgeryIchihara Hospital, Teikyo University, School of MedicineIchiharaJapan
  2. 2.Department of NeurosurgeryTeikyo University School of MedicineTokyo, 173Japan
  3. 3.Department of NeurosurgeryTeraoka Memorial HospitalShinichi-machi, HiroshimaJapan

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