[Lipo prostaglandin E1 administration in the acute stage following subarachnoid hemorrhage].
Prostaglandin (PG) E1 is a potent vasodilator on the peripheral vessels and also has an inhibitory action of platelet aggregation. Thus it is expected that PGE1 may be used for the treatment of cerebral vasospasm due to aneurysmal subarachnoid hemorrhage (SAH). Lipo-PGE1, lipid emulsified PGE1 less destroyed in the lung, has much longer half life time in the circulation than PGE1 which is rapidly inactivated in the lung. A pilot study, examining the clinical effect of Lipo-PGE1 on cerebral vasospasm, was performed. Of 27 patients with a ruptured anterior circulation aneurysm, who were operated on at acute stage, 12 were treated with Lipo-PGE1 and hypervolemic therapy (Lipo-PGE1 treated group) and 15 with hypervolemic only (control group). After the aneurysm was clipped, Lipo-PGE1, containing 15 micrograms of PGE1 was administered every 8 hours for 2 weeks. The appearance and severity of symptomatic vasospasm were less in the Lipo-PGE1 treated group than the control, and the outcome of the Lipo-PGE1 treated patients with or without vasospasm improved significantly at 1 month follow-up examination. The cerebral blood flow (CBF) measurements were performed three times, at first (1st), second to third (2nd) and fourth to sixth (3rd) week after SAH. In the Lipo-PGE1 treated group, the 1st CBF measurement was done before administration of Lipo-PGE1 started and the 2nd examination was performed after the completion of administration.(ABSTRACT TRUNCATED AT 250 WORDS)
Korosue
K
K
Department of Neurosurgery, Nagao Hospital, Kochi, Japan.
Kondoh
T
T
Ishikawa
A
A
Suzuki
H
H
Nagao
T
T
Tamaki
N
N
Matsumoto
S
S
D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005217:Fat Emulsions, Intravenous; D006801:Humans; D002532:Intracranial Aneurysm / Q000188:drug therapy; D002546:Ischemic Attack, Transient / Q000517:prevention & control; D008875:Middle Aged; D010865:Pilot Projects; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000503:physiopathology
D005217:Fat Emulsions, Intravenous; D000527:Alprostadil