A review of cerebral vasospasm in aneurysmal subarachnoid haemorrhage Part III: Mechanisms of action of calcium antagonists.
The possible mechanisms by which calcium antagonists are effective in the management of cerebral vasospasm are discussed. They number seven: relaxation of spastic arteries or prevention of spasm; opening up of collateral channels; neuronal protection at the membrane level; intracellular actions in neurones or vascular cells; alterations of blood rheology; antimitogenic effects; and improved fluid management of patients. A number of more minor actions may also be involved. It is likely that more than one mechanism is involved in their protective effect, especially at different periods in the time course of vasospasm.
Dorsch
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Department of Neurosurgery, Westmead Hospital, Sydney, Australia.