59. 脳血管攣縮に対する治療法:-実験的虚血脳に対する hydrogenated ergot alkaloids (HEA) 大量および glyceol の併用投与の効果と臨床的応用-

概要

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Cerebral vasospasm is one of the most disastrous problems in the treatment of ruptured intracranial aneurysms. Cerebral ischemia often develops in patients with vasospasm following subarachnoid hemorrhage and patients suffer from varying degree of neurological deficits. The purpose of this study is to evaluate effect of Hydergine and glyceol in the treatment of cerebral ischemia. 1) Experimental study The effect of Hydergine and glyceol on the regional cerebral blood flow (rCBF) was evaluated in the area of ischemia produced in the brain of mongrel dogs by occlusion of the middle cerebral artery. The rCBF was measured with the hydrogen clearance method. The rCBF significantly increased after intravenous infusion of Hydergine, 0.035mg/kg, and glyceol, 1g/kg. 2) Clinical study Three patients suffering from ischemic complications of vasospasm were treated with intravenous infusion of Hydergine, 3.6mg/day, and glyceol, 800ml/day. In two patients, neurological deficits completely disappeared within 2 weeks. In one patient, improvement of neurologic deficit was observed. In conclusion, intravenous infusion of Hydergine and glyceol could be beneficial symptomatic vasospasm.
The Japanese Society on Surgery for Cerebral Strokeの論文