Cerebral Vasospasm following Subarachnoid Hemorrhage—Experimental and Clinical Studies

• Published in: Neurologia medico-chirurgica Vol. 19; no. 1; pp. 73 - 81
• Main Authors: OHMOTO, Takashi, YOSHIOKA, Junji, SHIBATA, Kenji, MOROOKA, Hiroshi, MATSUMOTO, Yuzo, NISHIMOTO, Akira
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 1979
• Subjects: Aged; Animals; ascorbic acid; Ascorbic Acid - therapeutic use; Cats; Cerebral vasospasm; Female; fusaric acid; Humans; Ischemic Attack, Transient - drug therapy; Ischemic Attack, Transient - etiology; Male; methemoglobin; Middle Aged; o-phenanthroline; oxyhemoglobin; Subarachnoid Hemorrhage - complications
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.19.73

Delayed cerebral vasospasm was studied in exposed basilar arteries 3 days after cisternal injection of blood in cats. Substances containing heme components such as oxyhemoglobin, methemoglobin, catalase, NADH and methemalbumin, induced profound vasospasm when applied topically. All products released from erythrocytes with heme components may be responsible for delayed cerebral vasospasm. Vasospasm produced by incubated blood-CSF mixture was relieved by topical application of fusaric acid, methylprednisolone, salbutamol, o-phenanthroline or ascorbic acid. Levels of cyclic AMP in cerebral vessels were slightly increased after cisternal injection of ascorbic acid (100 mg), as well as aminophylline (25 mg). Patients with vasospasm following subarachnoid hemorrhage were treated with intrathecal administration of ascorbic acid (200-1, 000 mg). Of 5 treatment trials, there were 2 definite beneficial responses. Certain improvements were obtained in patients who were treated with ascorbic acid within 16 hours after the onset of symptoms.