28. 攣縮脳血管に対する Nimodipine (Ca-antagonist) の臨床例における効果

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Nimodipine (Nimo.) is Ca-antagonist which is considered to have a vasodilating effect on cerebral arteries. Authors studied the vasodilating effect of Nimo. on human cerebral arteries in 22 cases with ruptured intracranial aneurysms. Studies consisted of two steps. In the first step, 0.004% Nimo. was topically administered to cerebral arteries during aneurysmal surgery (3±1 day after onset). In the second step, 200μg of Nimo. was topically administered via cisternal drainage tube postoperatively (8±3 days after onset), and cerebral angiography was carried out to evaluate the changes of arterial diameter. Among those postoperative cases, 6 cases were administered additional 200 μg of Nimo. intravenously at the same time.<BR>In the first step, non-spastic cerebral arteries were dilated by Nimo. in almost all cases. In the second step, non-spastic arteries also dilated in 3 of 4 non-spastic cases. But, vasospastic arteries dilated only in 5 of 15 cases, and those effective cases were in the early stage from the appearance of mild to moderate vasospasms. Furthermore, the dilating ratio was higher in cases with both intracisternal and intravenous administration of Nimo.<BR>From those results, it is considered that Nimo. may be able to prevent the appearance of vasospasms, but the method of administration must be studied in the future.
The Japanese Society on Surgery for Cerebral Strokeの論文