Comparison of intrathecal cilostazol and nimodipine treatments in subarachnoid hemorrhage: an experimental study in rabbits.
OBJECTIVE
intrathecal administration of calcium channel antagonists has been proposed to reduce cerebral vasospasm (CVS) in animal subarachnoid hemorrhage (SAH) models. Also, delayed CVS treatment model with oral administration of cilostazol can be seen in the literature.


METHODS
in this study, 25 male New Zealand white rabbits were randomly assigned to five groups: control, SAH only, SAH/nimodipine, SAH/cilostazol, SAH/vehicle. The animals' basilar arteries were sectioned from four separate zones and four sections were obtained from each rabbit. Basilar artery luminal section areas were measured by using SPOT for windows Version 4.1 computer program.


RESULTS
basilar artery luminal section areas in SAH/ nimodipine and SAH/ cilostazol groups were significantly higher than SAH only group (P < 0.05).


CONCLUSIONS
phosphodiesterase 3 inhibitor cilostazol has vasodilatory effects without affecting cerebral blood flow. Nimodipine is a calcium channel blocker and is still used in vasospasm therapy either oral or intravenously. This study demonstrates that prophylactic bolus intrathecal administration of either cilostazol or nimodipine equally prevents SAH-associated CVS in an animal model. We therefore propose that cilostazol is a candidate for clinical trials in the treatment of delayed vasospasm.
Department of Neurosurgery, Hacettepe University School of Medicine, Ugur Mumcunun Sokak, 78/2, 06700, Gaziosmanpasa, Ankara, Turkey. bulentonal@hotmail.com
Mehmet Bulent
MB
Onal
Burcak
B
Bilginer
Firat
F
Narin
M Ibrahim
MI
Ziyal
Figen
F
Soylemezoglu
Tuncalp
T
Ozgen
D000704:Analysis of Variance; D000818:Animals; D001488:Basilar Artery / Q000187:drug effects / Q000473:pathology; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D000077407:Cilostazol; D004195:Disease Models, Animal; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D007278:Injections, Spinal / Q000379:methods; D008297:Male; D009553:Nimodipine / Q000627:therapeutic use*; D011817:Rabbits; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy*; D013777:Tetrazoles / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D005343:Fibrinolytic Agents; D013777:Tetrazoles; D009553:Nimodipine; D000077407:Cilostazol