title: Convulsion during intra-arterial infusion of fasudil hydrochloride for the treatment of cerebral vasospasm following subarachnoid hemorrhage.
abstract: The incidence of convulsion and associated factors were retrospectively analyzed in 23 patients with symptomatic cerebral vasospasm following subarachnoid hemorrhage (SAH) who underwent a total of 31 intra-arterial infusion of fasudil hydrochloride (IAFH) procedures in 49 vessels. Fasudil hydrochloride was administered by superselective infusion via a microcatheter positioned at the proximal portion of the affected artery. Thirteen procedures were performed by manually controlled infusion of 30-75 mg fasudil hydrochloride (1.2-3.75 mg/ml) for approximately 10 minutes. Eighteen procedures were performed by continuous infusion of 60 mg fasudil hydrochloride (1.2 mg/ml) by infusion pump at a constant rate of 3 mg/min. Neurological improvement was observed after 18 of 22 procedures in patients with neurological deterioration due to vasospasm. Convulsion during IAFH developed in 4 patients, all treated by manual infusion (p < 0.05). The manual infusion method (p < 0.05) and infusion rate greater than 3 mg/min (p < 0.01) were significantly associated with the incidence of convulsion during IAFH. IAFH was effective for treating cerebral vasospasm following aneurysmal SAH. IAFH at a constant rate of 3 mg/min delivered by infusion pump improved the symptoms of cerebral vasospasm and prevented convulsions during IAFH.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan. enomoto@gifu-u.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshimura
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Yamada
authors.forename: Toru
authors.initials: T
authors.lastname: Iwama
mesh_terms: D019307:1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage; D002404:Catheterization / Q000379:methods / Q000592:standards; D002536:Cerebral Arteries / Q000187:drug effects / Q000503:physiopathology; D003975:Diazepam / Q000008:administration & dosage; D004333:Drug Administration Routes; D005260:Female; D006801:Humans; D007260:Infusion Pumps / Q000009:adverse effects / Q000592:standards; D007261:Infusions, Intra-Arterial / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D020301:Vasospasm, Intracranial / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants; D014665:Vasodilator Agents; D019307:1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine; C049347:fasudil; D003975:Diazepam