Cilostazol May Prevent Cerebral Vasospasm Following Subarachnoid Hemorrhage

• Published in: Neurologia medico-chirurgica Vol. 49; no. 6; pp. 235 - 241
• Main Authors: YOSHIMOTO, Tetsuyuki, SHIRASAKA, Tomohide, FUJIMOTO, Shin, YOSHIDUMI, Takeshi, YAMAUCHI, Tohru, TOKUDA, Kouichi, KANEKO, Sadao, KASHIWABA, Takeshi
• Format: Journal Article
• Language: English
• Published: Japan The Japan Neurosurgical Society 2009
• Subjects: Brain Ischemia - drug therapy; Brain Ischemia - etiology; Brain Ischemia - prevention & control; Cerebral Angiography; Cerebral Arteries - diagnostic imaging; Cerebral Arteries - drug effects; Cerebral Arteries - physiopathology; Cerebral Infarction - drug therapy; Cerebral Infarction - etiology; Cerebral Infarction - prevention & control; Cilostazol; Disability Evaluation; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Outcome Assessment (Health Care); Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - adverse effects; Postoperative Care - methods; Postoperative Care - statistics & numerical data; Recovery of Function - drug effects; Recovery of Function - physiology; Retrospective Studies; Severity of Illness Index; subarachnoid hemorrhage; Subarachnoid Hemorrhage - complications; Tetrazoles - administration & dosage; Tetrazoles - adverse effects; Treatment Outcome; Vasodilator Agents - administration & dosage; Vasodilator Agents - adverse effects; vasospasm; Vasospasm, Intracranial - drug therapy; Vasospasm, Intracranial - etiology; Vasospasm, Intracranial - prevention & control
• ISSN: 0470-8105; 1349-8029
• DOI: 10.2176/nmc.49.235

Cilostazol is an antiplatelet aggregation inhibitor drug associated with increased cerebral blood flow and inflammation suppression. This study evaluated administration of cilostazol to prevent cerebral vasospasm following subarachnoid hemorrhage (SAH) in 50 patients treated surgically from December 2004 to November 2006. All patients, excluding those with Hunt and Kosnik grade 5 or who had undergone late surgery, were classified into two groups: 26 patients who received 200 mg/day cilostazol from postoperative day 1 to day 14 and 24 control patients. The frequency and the degree of cerebral vasospasm, occurrence of ischemic lesion, and clinical symptoms due to vasospasm were compared between the two groups. The appearance of severe vasospasm on angiography, persistent symptomatic spasm, and new cerebral infarction due to vasospasm demonstrated by neuroimaging were apparently lower in the cilostazol group than in the control group, suggesting that cilostazol may significantly suppress cerebral vasospasm following SAH.