Drotaverinum – a new modality of prevention and treatment in cerebral vasospasm after subarachoidian hemorrhage?

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Aim: This study want to demonstrate the efficaciousness of drotaverinum as a replacer of papaverine in the prevention and treatment of vasospasm.

Material and method: In this study were used 20 albino Wistar male rats. Rats were divided in two groups and vasospasm was induced to the both femoral artery and after that irrigation of the femoral arteries with drotaverinum was performed to demonstrate the vasodilatation that can appear (group A). In the group B after the obtaining of vasospasm irrigation of the femoral arteries with saline solution was performed and this group was used as witness. The length of the vessels was measured when was achieved the vasospasm and also before and after the administration of the solutions. Pictures were taken at every step of dissection and solutions administration to can measure the length of arteries before and after the administration of drotaverinum and the saline solution.

Results: In all rats was obtained vasospasm at the femoral artery after clipping the artery and after we irrigate with adrenaline. In the group with drotaverinum we obtained the vasodilatation and in the witness group the caliber of the vessels remain the same. The statistical analysis of the data demonstrate a significant differences between the group were was used drotaverinum and the witness group were was used the saline solution (p<0,001).

Conclusions: Drotaverinum has a good vasodilatative effect on arteries and he can prevent the apparition of vasospasm and it can even treat vasospasm if occur by producing local vasodilatation and a good circulation in the area where is administrated. This study showed quantitatively that drotaverinum can treat the experimental peripheral vasospasm in rats.

1. Keyrouz SG, Diringer MN. Clinical review: Prevention and therapy of vasospasm in subarachnoid hemorrhage. Critical care. 2007;11(4):220.

2. Athar MK, Levine JM. Treatment options for cerebral vasospasm in aneurysmal subarachnoid hemorrhage. Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics. 2012;9(1):37-43.

3. Ladner TR, Zuckerman SL, Mocco J. Genetics of cerebral vasospasm. Neurology research international. 2013;2013:291895.

4. Odom MJ, Zuckerman SL, Mocco J. The role of magnesium in the management of cerebral vasospasm. Neurology research international. 2013;2013:943914.

5. Diringer MN. Management of aneurysmal subarachnoid hemorrhage. Critical care medicine. 2009;37(2):432-40.

6. Kistka H, Dewan MC, Mocco J. Evidence-based cerebral vasospasm surveillance. Neurology research international. 2013;2013:256713.

7. Kim JH, Yi HJ, Ko Y, Kim YS, Kim DW, Kim JM. Effectiveness of papaverine cisternal irrigation for cerebral vasospasm after aneurysmal subarachnoid hemorrhage and measurement of biomarkers. Neurological sciences: official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2014;35(5):715-22.

8. Jabbarli R, Glasker S, Weber J, Taschner C, Olschewski M, Van Velthoven V. Predictors of severity of cerebral vasospasm caused by aneurysmal subarachnoid hemorrhage. Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association. 2013;22(8):1332-9.

9. Kerz T, Boor S, Beyer C, Welschehold S, Schuessler A, Oertel J. Effect of intraarterial papaverine or nimodipine on vessel diameter in patients with cerebral vasospasm after subarachnoid hemorrhage. British journal of neurosurgery. 2012;26(4):517-24.

10. Lee Y, Zuckerman SL, Mocco J. Current controversies in the prediction, diagnosis, and management of cerebral vasospasm: where do we stand? Neurology research international. 2013;2013:373458.

11. Siasios I, Kapsalaki EZ, Fountas KN. Cerebral vasospasm pharmacological treatment: an update. Neurology research international. 2013;2013:571328.

12. Reddy D, Fallah A, Petropoulos JA, Farrokhyar F, Macdonald RL, Jichici D. Prophylactic magnesium sulfate for aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Neurocritical care. 2014;21(2):356-64.

13. Cossu G, Messerer M, Oddo M, Daniel RT. To look beyond vasospasm in aneurysmal subarachnoid haemorrhage. BioMed research international. 2014;2014:628597.

14. Aydin HE, Ozbek Z, Aydin N, Bolluk O, Vural M, Arslantas A, et al. Application of lumbar drainage in vasospasm after spontaneous subarachnoid hemorrhage and prevention of late cerebral infarction. Acta neurochirurgica Supplement. 2015;120:255-8.

15. Macdonald RL, Diringer MN, Citerio G. Understanding the disease: aneurysmal subarachnoid hemorrhage. Intensive care medicine. 2014;40(12):1940-3.

16. Raya AK, Diringer MN. Treatment of subarachnoid hemorrhage. Critical care clinics. 2014;30(4):719-33.

17. Heffren J, McIntosh AM, Reiter PD. Nimodipine for the prevention of cerebral vasospasm after subarachnoid hemorrhage in 12 children. Pediatric neurology. 2015;52(3):356-60.

Romanian Neurosurgery

The Journal of Romanian Society of Neurosurgery

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