Intracisternal versus intracarotid infusion of L-arginine in experimental cerebral vasospasm.
OBJECTIVE
The effect of short term intracisternal and intracarotid L-arginine infusion on experimental cerebral acute phase vasospasm in a rabbit subarachnoid haemorrhage model is investigated, and the two groups compared.


METHODS
Subarachnoid haemorrhage was produced by intracisternal injection of autologous blood in New Zealand rabbits. On the fourth day after subarachnoid haemorrhage, cerebral blood flow was monitored using transcranial Doppler ultrasonography during intracisternal and intracarotid saline and L-arginine infusions.


RESULTS
Cerebral blood flow measurements revealed resolution of vasospasm with short-term intracisternal and intracarotid L-arginine infusion. No significant difference was found between the effects of intracisternal and intracarotid L-arginine infusions, however intracarotid L-arginine infusion created a more potent vasodilatation towards the end of infusion.


CONCLUSIONS
Both intracisternal and intracarotid short term L-arginine infusion significantly improve acute phase cerebral vasospasm after experimental subarachnoid haemorrhage. Intracarotid L-arginine infusion is more potent and safer as large amounts of intracisternal L-arginine may lead to overproduction of nitric oxide by inducible nitric oxide synthase with the production of free radicals.
Ozüm
Unal
U
Department of Neurosurgery, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
Aslan
Adem
A
Karadağ
Ozen
O
Gürelik
Mustafa
M
Taş
Ayşenur
A
Zafer Kars
H
H
D000818:Animals; D001120:Arginine / Q000008:administration & dosage / Q000502:physiology*; D001783:Blood Flow Velocity / Q000187:drug effects; D002343:Carotid Artery, Internal; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D002946:Cisterna Magna; D005260:Female; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D019001:Nitric Oxide Synthase / Q000187:drug effects / Q000502:physiology; D011817:Rabbits; D011897:Random Allocation; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000517:prevention & control*
D001120:Arginine; D019001:Nitric Oxide Synthase