Roles of subarachnoid blood clots and norepinephrine in cerebral vasospasm
- 24 Downloads
The content of norepinephrine (NE) in the ventricular, basal cisternal and lumbar cerebrospinal fluid (CSF) was determined in 19 patients with ruptured cerebral aneurysms. The cisternal CSF in patients with vasospasm contained a significantly higher level of NE (0.246 ± 0.049 ng/ml) compared with those without vasospasm (0.075 ± 0.001 ng/ml) (p < 0.001). However, this increase is not considered to be high enough to constrict cerebral arteries, unless there is an increased NE-sensitivity in subarachnoid haemorrhage. Vascular responses to NE in vivo were then studied after reversing blood-induced prolonged vasospasm of the rabbit's basilar artery through a transclival approach as well as a newly developed basal cisternal irrigation model. However, NE in molar concentrations between 1 × 10−10 and 10−2 failed to produce further contraction of the artery. In conclusion, the increase in NE with vasospasm might be only a secondary phenomenon, and not a causative factor of vasospasm. Early removal of subarachnoid blood clots seemed to prevent the development of vasospasm.
KeywordsNorepinephrine Cerebrospinal Fluid Interventional Radiology Cerebral Artery Causative Factor
Unable to display preview. Download preview PDF.
- 1.Benedict, C. R., Loach, A. B., Sympathetic nervous system activity in patients with subarachnoid hemorrhage. Stroke9 (1978), 237–244.Google Scholar
- 2.Cummins, B. H., Lothian, D., Amine levels in the cerebrospinal fluid after subarachnoid haemorrhage. Brit. J. Surg.60 (1973), 910–913.Google Scholar
- 3.Duckles, S. P., Kim, J., Bevan, R. D., Bevan, J. A., Alteration of innervation and reactivity of monkey cerebral arteries after subarachnoid hemorrhage. Stroke8 (1977), 10–15.Google Scholar
- 4.Echlin, F., Experimental vasospasm, acute and chronic, due to blood in the subarachnoid space. J. Neurosurg.35 (1971), 646–656.Google Scholar
- 5.Peerless, S. J., Kendall, M. J., The innervation of the cerebral blood vessels. In: Subarachnoid Hemorrhage and Cerebrovascular Spasm (Smith, R. R.,et al., eds.), pp. 38–54. Springfield. Ill.: Ch. C Thomas. 1975.Google Scholar
- 6.Peerless, S. J., Griffiths, J. G., Plasma catecholamines following subarachnoid hemorrhage. In: Subarachnoid Hemorrhage and Cerebrovascular Spasm (Smith, R. R.,et al., eds.), pp. 148–156. Springfield, Ill.: Ch. C Thomas. 1975.Google Scholar
- 7.Sano, K., Saito, I., Early operation and washout of blood clots for prevention of cerebral vasospasm. In: Cerebral Arterial Spasm (Wilkins, R. H., ed.), pp. 510–513. Baltimore-London: Williams and Wilkins. 1980.Google Scholar
- 8.Svendgaard, N.-Aa., Edvinson, L., Owman, Ch., Sahlin, Ch., Increased sensitivity of the basilar artery to norepinephrine and 5-hydroxytryptamine following experimental subarachnoid hemorrhage. Surg. Neurol.8 (1977), 191–195.Google Scholar
- 9.White, R. P., Huang, S. P., Hagen, A. A., Robertson, J. T., Experimental assessment of phenoxybenzamine in cerebral vasospasm. J. Neurosurg.50 (1979), 158–163.Google Scholar