title: Intra-arterial dantrolene for refractory cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Intravenous dantrolene has been used to prevent and treat cerebral vasospasm. We report a case of refractory cerebral vasospasm treated with intra-arterial dantrolene after aneurysmal subarachnoid hemorrhage.
  
  
  METHODS
  A 56-year-old woman suffered a diffuse subarachnoid hemorrhage from a ruptured anterior communicating artery aneurysm which was successfully treated with coil embolization. She subsequently developed bilateral severe angiographic vasospasm which was treated with intra-arterial vasodilators. However, owing to the recurrence of vasospasm, intra-arterial dantrolene followed by balloon angioplasty was used.
  
  
  RESULTS
  There was moderate improvement of the severe vasospasm in bilateral A1 segments of the anterior cerebral arteries after microcatheter-based intra-arterial infusion of 30 ml (1 mg/ml) dantrolene. Patient's hemodynamic parameters were monitored during and after the procedure and no significant changes were seen after dantrolene infusion. A follow up cerebral angiogram after 1 day demonstrated the persistence of therapeutic effect.
  
  
  CONCLUSIONS
  Intra-arterial dantrolene induced a sustained improvement in cerebral vasospasm secondary to ruptured aneurysm. No significant side effects were observed during or after the infusion of the drug.
authors: Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, MN, USA. drsmajidi@gmail.com
authors: Shahram
authors: S
authors: Majidi
authors: Mikayel
authors: M
authors: Grigoryan
authors: Wondwossen G
authors: WG
authors: Tekle
authors: Adnan I
authors: AI
authors: Qureshi
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D003620:Dantrolene / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008875:Middle Aged; D009125:Muscle Relaxants, Central / Q000008:administration & dosage*; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D020301:Vasospasm, Intracranial / Q000150:complications / Q000188:drug therapy*
chemical_list: D009125:Muscle Relaxants, Central; D003620:Dantrolene