[The effects of ticlopidine and nicardipine on the prevention of symptomatic vasospasm after aneurysmal rupture].
From the previous reports that the pathogenesis of cerebral vasospasm is most likely multifactorial process and that early removal of the clot may decrease the incidence or severity of the ischemic deficits and also that antifibrinolytic therapy increases the incidence and the severity of the symptomatic vasospasm, we attempted at prevention of the symptomatic vasospasm in aneurysmal patients with our own protocol. One hundred twenty-one consecutive patients with a ruptured aneurysm were operated upon within 48 hours after subarachnoid hemorrhage. Seventy-seven patients in group (A) were treated with a regimen of postoperative Ticlopidine and Nicardipine without antifibrinolytic therapy. Fifty-four patients in group (B) were not treated with the above regimen. Symptomatic vasospasm occurred only in four patients (5%) in group (A), but in 18 patients (33%) in group (B). In total series, 82% in group (A) and 63% in group (B) had an excellent to good outcome. Nine % in group (A) and 20% in group (B) had a poor outcome. The results indicate that our protocol with Ticlopidine and Nicardipine can reduce the incidence of symptomatic vasospasm following the aneurysmal rupture.
Fujita
K
K
Department of Neurosurgery, Kobe University, School of Medicine, Japan.
Yamashita
H
H
Masumura
M
M
Ehara
K
K
Tamaki
N
N
Matsumoto
S
S
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000601:surgery; D002546:Ischemic Attack, Transient / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009529:Nicardipine / Q000008:administration & dosage / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D012422:Rupture, Spontaneous; D013988:Ticlopidine / Q000008:administration & dosage / Q000627:therapeutic use*
D010975:Platelet Aggregation Inhibitors; D009529:Nicardipine; D013988:Ticlopidine