Cerebral vasospasm

Tseng MY, Czosnyka M, Richards H, Pickard JD, Kirkpatrick PJ. Effects of acute treatment with pravastatin on cerebral vasospasm, autoregulation, and delayed ischemic deficits after aneurysmal subarachnoid hemorrhage a phase II randomized placebo-controlled trial. Stroke 2005 36 1627-1632. 

Kassell, N.F., Haley, E.C., Halves, W.M., Hunsen, C.A. and Weir, B. (1993). Phase two trial of tirilazad in aneurysmal subarachnoid hemorrhage. Vth International Symposium on Cerebral Vasospasm, Edmonton and Jasper, Alberta, Canada, May 18-21. Can. J. Neurol. Sci. 20, S29. 

Tokiyoshi K, Ohnishi T, Nii Y. 1991. Efficacy and toxicity of thromboxane synthetase inhibitor for cerebral vasospasm after subarachnoid hemorrhage. Surg Neurol 36 112-118. 

Wl. White, R. R, Comparison of the inhibitory effects of antithrombin 111, 0 -2-macroglobulin, and thrombin in human basilar arteries Relevance to cerebral vasospasm. J. Cereb. Blood Flow Metab. 7(1), 68-73 ( 1987). 

W3. White, R. P, and Robertson, J. T., Role of plasmin, thrombin, and antithrombin 111 as etiological factors in delayed cerebral vasospasm. Neurosurgery. 16(1), 27-35 (1985). 

Parke-Davis workers have performed SAR studies on endothelin receptor antagonists derived from a dimethoxy-substituted oxicam in the search of treatments for hypertension, congestive heart failure, renal failure, pulmonary hypertension, ischemia, and cerebral vasospasm <1998BMC1447>. Compound 295 displayed a 40-fold selectivity for endothelin receptor antagonist A (ETa) over endothelin receptor antagonist B (ETb) (Figure 26). 

Mechanism of Action A cerebral vasospasm agent that inhibits movement of calcium ions across vascular smooth-muscle cell membranes, T herapeuticEffect Produces fa-... 

Unlabeled Uses Cerebral vasospasm, migraines, Raynaud s syndrome, reflex sympathetic dystrophy, refractory depression, tardive dyskinesia, thyrotoxic crisis. 

Y. Handa, T. Kubota, A. Tsuchida, M. Kaneko, H. Caner, H. Kobayashi and T. Kubota, Effect of systemic hypotension on cerebral energy metabolism during chronic cerebral vasospasm in primates. /. Neurosurg., 1993, 78,112-119. 

Cerebral Vasospasm and Infarct Following Subarachnoid Hemorrhage... 

Nimodipine, a member of the dihydropyridine group of calcium channel blockers, has a high affinity for cerebral blood vessels and appears to reduce morbidity after a subarachnoid hemorrhage. Nimodipine was approved for use in patients who have had a hemorrhagic stroke, but it has recently been withdrawn. Nicardipine has similar effects and is used by intravenous and intracerebral arterial infusion to prevent cerebral vasospasm associated with stroke. Verapamil as well, despite its lack of vasoselectivity, is used by the intra-arterial route in stroke. Some evidence suggests that calcium channel blockers may also reduce cerebral damage after thromboembolic stroke. 

Cerebral vasospasm following aneurysmal subarachnoid haemorrhage is one... 

Conway JE, Tamargo RJ. Cocaine use is an independent risk factor for cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Stroke 2001 32(10) 2338-43. 

As noted in Chapter 3, endothehns rank among the most potent known vasoconstricting agents they have been imphcated in a number of diseases including cerebral vasospasm and pulmonary hypertension. The stereoselective synthesis of an endothelin antagonist begins with the... 

Medele, R.J. Stummer, W. Reulen, H.J. Steiger, H.J. Evidence for peroxidative damage by nitric oxide in experimental chronic cerebral vasospasm. Neurol. Res. 1996,18, 277-280. 

Trials of the effects of endothelin receptor antagonists in patients with heart failure, coronary artery disease, arterial hjtpertension, and pulmonary hjtpertension have been reviewed (6), as have their uses in treating cancers (7) and cerebral vasospasm (8), and their potential uses in atherosclerosis, re-stenosis, myocarditis, shock, and portal hypertension (9)... 

Hodge CJ Jr. Endothelin receptor antagonists and cerebral vasospasm an npdate. Nenrosnrgery 2002 51(6) 1333 2. 

Stroke and ischemic encephalopathy, probably caused by cerebral vasospasm after intravenous immunoglobulin, have been reported as possible comphcations of intravenous immunoglobuhn (63). 

Cerebral vasospasm, cerebral vasculitis, and serum hjrperviscosity have been implicated in the pathogenesis of cerebral infarction after intravenous immunoglobulin (66). 

Sztajzel R, Le Floch-Rohr J, Eggimann P. High-dose intravenous immunoglobulin treatment and cerebral vasospasm A possible mechanism of ischemic encephalopathy Eur Neurol 1999 41(3) 153-8. 

Aseptic meningitis can occur 3-67 days after myelography, and in one case it was associated with evidence of cerebral vasospasm and infarction. An unusual ophthalmic complication in another patient followed the passage... 

Nimodipine has been routinely used to reduce cerebral vasospasm in patients with subarachnoid hemorrhage. A randomized, double-blind, placebo-controlled trial was stopped early because of excess mortality (8/75 versus 1/74 deaths with nimodipine and placebo respectively), which was attributed to an increased incidence of surgical bleeding (4). In addition, its use for cerebral protection in a cardiac valve replacement trial involving cardiopulmonary bypass was also terminated prematurely because of increased cerebrovascular complications and excessive blood loss in a small subgroup of patients (5). In traumatic subarachnoid hemorrhage, a... 

The authors reviewed a number of other case reports of phenylpropanolamine-induced cerebral vasospasm associated with hemorrhages and drew a parallel with similar effects of amfetamines. 

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