Cerebrovascular spasm

The most serious toxic effects of cocaine involve changes in the cardiovascular system. These include cardiac arrhythmias, myocardial ischaemia and infarction, and cerebrovascular spasm, all of which can be largely explained by the facilitation of the action of catecholamines on the cardiovascular system. Another explanation of the cardiotoxicity of cocaine lies in the direct vasoconstrictive properties of its major metabolite, norcocaine. It seems likely... 

We speculate that ischemia induces changes in the tubulo-interstitium by such factors as oxidative stress, apoptosis, an increase in intracellular Ca, complement activation, ICAM-1 expression, and inflammation, in a region controlled by the blood vessels, thereby influencing the blood vessels and prolonging vascular spasm. Coronary spasm persists for 15min, and cerebrovascular spasm in the presence of subarachnoid hemorrhage persists for a week in some patients. Therefore, renovascular spasm may persist for a long period. 

MI, cerebrovascular spasm, and cerebrovascular occlusion have followed phentolamine administration, usually in association with marked hypotensive episodes with shock-like states that occasionally follow parenteral use. 

The possibility of cerebrovascular action of PCP was raised by the development of focal seizures and hemiparesis in a 6-year-old boy who had ingested what was presumed to be PCP (18). Hypertensive encephalopathy with a blood pressure of260/160 occurred in an 18-year-old woman who used PCP (43). These clinical findings are compatible with in vitro studies indicating that cerebral artery spasms can be produced by PCP as well as by LSD and mescaline (4). Whether such cerebrovascular actions are pertinent to the mental effects of these drugs is questionable. 

It is indicated in spasticity due to neurological disorders e.g., multiple sclerosis, chronic myelopathy, degenerative diseases of the spinal cord, cerebrovascular accidents and cerebral palsy painful muscle spasm associated with static and functional disorders of the spine (cervical and lumbar syndromes) painful muscle spasm following surgery e.g., for herniated intervertebral disc or for osteoarthritis of the hip. 

Liver-wind disturbance Epilepsy, severe case of hypertension and glaucoma, facial paralysis, facial spasms, cerebrovascular accident and its sequelae. 

Rheumatic arthritis, rheumatoid arthritis, cervical or lumbar spondylosis, osteoarthritis, sciatica, Raynaud s disease, vasculitis, pulmonary heart disease, rheumatic heart disease, coronary heart disease, migraine, hemiplegia after cerebrovascular accident, paralysis, facial paralysis, facial spasm, skin diseases that are influenced by changes in the weather and are characterized by itchy, weeping, red or dry skin lesions. 

Cerebrovascular Carotid spasm Compromise of ECA ostium Hyperfusion syndrome Contrast encephalopathy Transient symptomatic cerebral ischemia Global Focal Carotid dissection Carotid perforation Hyperperfusion syndrome Acute stent thrombosis Major ischemic stroke Cerebral hemorrhage... 

Indications Liver/kidney yin deficiency, liver yang ascendancy, qi and blood counterflow and chaos. Wind stroke, convulsions, epilepsy, cerebrovascular accident, aphasia, apraxia, renal hypertension, essential hypertension, hypertensive encephalopathy, cerebral arteriosclerosis, arteriosclerotic heart disease, hyperthyroidism, premenstrual tension, postpartum fever with spasms and convulsions, and glaucoma... 

Ethaverine, an isoquinoline derivative with peripheral vasodilating properties (100 to 200 mg p.o. t.i.d. q. 12 hours), is indicated in peripheral and cerebrovascular insufficiency associated with arterial spasm and in spastic conditions of the gastrointestinal and genitourinary tracts. 

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