26. 脳血管攣縮に対するCa++拮抗剤の効果

概要

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Effect of Ca++ antagonist (nifedipine) on experimental and clinical vasospasm was examined. In experimental animals, vasospasm was produced by dripping BaCl2 solution on the middle cerebral artery. After topical application of BaCl2, the cerebral arteries revealed severe vasospasm for 40 min. Regional cerebral blood flow, measured with H2 clearance method, markedly decreased during the vasospasm. Nifedipine, administered systemically 10 min after BaCl2 dripping, caused vasodilatation and increase of regional cerebral blood flow. In clinical study, nifedipine (70-160mg/d) was administered systemically 7 patients with vasospasm. Fifteen minutes after nifedipine administration, A1 and C1 portions of cerebral arteries revealed vasodilatation (C1: 25% and A1: 11.4%) on carotid angiographies. Clinical symptoms and signs resulted from cerebral vasospasm disappeared in 6 out of 7 patients after nifedipine treatment. Nifedipine exerted excellent effect in patients with mild to moderate vasospasm, but no effect in patient with severe vasospasm.
The Japanese Society on Surgery for Cerebral Strokeの論文