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Beta-blockade in acute aneurysmal subarachnoid haemorrhage

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Summary

The effects of beta-blockade to prevent autonomic disorders after acute aneurysmal subarachnoid haemorrhage were prospectively investigated. 11 patients were treated with the beta-1-selective beta-blocker metoprolol (up to 200 mg/die intravenously). 14 patients received standard therapy as controls. Pulse rate, blood pressure and dosage of the additional antihypertensive medication as signs of sympathetic disturbance were registered. The main result was the normalizing of the pulse rate especially during the first two weeks in contrast to the control group. The patients in the beta-blocker group did not need further antihypertensive medication. This was mainly a result of the reduction in sympathetic activation. No severe side-effects were documented and the survival was better in the treated group. Thus, beta-blockade is able to prevent and reduce autonomic disorders, especially activation of the sympathetic tone, in subarachnoid haemorrhage. Metoprolol as a so called cardioselective beta-blocker seems to be one of the suitable agents and is considered superior to the non-selective agents.

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References

  1. Benedict CR, Loach AB (1978) Sympathetic nervous system activity in patients with SAH. Stroke 9: 237–244

    PubMed  Google Scholar 

  2. Cameron MM, Haas RH (1976) Adrenergic blockade in subarachnoid haemorrhage. Acta Neurochir (Wien) 34: 261–264

    Google Scholar 

  3. Clark BJ (1982) Beta-adrenoceptor-blocking agents: are pharmacologic differences relevant? Am Heart J 104: 334–346

    PubMed  Google Scholar 

  4. Crompton MR (1963) Hypothalamic lesions following the rupture of cerebral berrry aneurysms. Brain 86: 491–510

    Google Scholar 

  5. Cruickshank JM, Neil-Dwyer G, Scott AW (1974) Possible role of catecholamines, corticosteroides and potassium in production of electrocardiographic abnormalities associated with subarachnoid haemorrhage. Br Heart J 36: 697–706

    PubMed  Google Scholar 

  6. Cruickshank JM, Neil-Dwyer G, Lane J (1975) The effect of oral propranolol upon the ECG changes occuring in subarachnoid haemorrhage. Cardiovasc Res 9: 236–245

    PubMed  Google Scholar 

  7. Doshi R, Neil-Dwyer G (1977) Hypothalamic and myocardial lesions after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 40: 821–826

    PubMed  Google Scholar 

  8. Hamann G, Stober T, Biro G, Freier G, Holzer G, Schimrigk K (1985) Relationship of plasma renin activity to the degree of impaired consciousness in spontaneous subarachnoid haemorrhage. J Neurol 232: 193

    Google Scholar 

  9. Hamann G, Stober T, Biro G, Anstätt T, Schimrigk K (1986) The relationship between plasma renin activity and the degree of impaired consciousness in spontaneous subarachnoid haemorrhage. In: Stober T, Schimrigk K, Ganten D, Sherman DG (eds) Central nervous system control of the heart. Martinus Nijhoff, Boston, pp 153–161

    Google Scholar 

  10. Hamann G, Stober T, Schimrigk K (1989) Has plasma renin activity a prognostic significance in subarachnoid haemorrhage. Acta Neurochir (Wien) 100: 25–30

    Google Scholar 

  11. Heros RC, Zervas NT (1983) Subarachnoid haemorrhage. Annu Rev Med 75: 367–375

    Google Scholar 

  12. Marion DW, Segal R, Thompson ME (1986) Subarachnoid haemorrhage and the heart. Neurosurgery 18: 101–106

    PubMed  Google Scholar 

  13. McBoyle D, Barber JM, McIImoyle EL, Salathia KS, Evans AE, Gran G, Elwood JH, Shanks RG (1983) Effect of very early intervention with metoprolol on myocardial infarct size. Br Heart J 40: 229–233

    Google Scholar 

  14. Meyer JS, Okamoto S, Shimazu K, Koto A, Ohuchi T, Sari A, Ericsson AD (1974) Cerebral metabolic changes during treatment of subacute cerebral infarction by alpha and beta adrenergic blockade with phenoxybenzamine and propanolol. Stroke: 5: 180–192

    PubMed  Google Scholar 

  15. MIAMI Trial Research group (1985) Metoprolol in acute myocardial infarction (MIAMI). A randomised placebo-controlled international trial. Eur Heart J 6: 199–226

    Google Scholar 

  16. Minegishi A, Ishizaki T, Yoshida Y, Ahagon A, Shibata N, Kobayashi H (1987) Plasma monoaminergic metabolites and catecholamines in subarachnoid haemorrhage. Arch Neurol 44: 423–428

    PubMed  Google Scholar 

  17. Neil-Dwyer G, Walter P, Shawe HJH, Doshi R, Hodge M (1980) Plasma renin activity in patients after a subarachnoid haemorrhage — a possible predictor of outcome. Neurosurgery 7: 578–582

    PubMed  Google Scholar 

  18. Neil-Dwyer G, Walter P, Cruickshank JM, Stratton C (1983) Beta-blockade in subarachnoid haemorrhage. Drugs [Suppl] 25: 273–277

    Google Scholar 

  19. Neil-Dwyer G, Walter P, Cruickshank JM (1985) Beta-blockade benefits patients following a subarachnoid haemorrhage. Eur J Clin Pharmacol [Suppl] 28: 25–29

    Google Scholar 

  20. Neil-Dwyer G, Cruickshank JM, Doshi R (1990) The stress response in subarachnoid haemorrhage. Acta Neurochir (Wien) [Suppl] 47: 102–110

    Google Scholar 

  21. Norris JW (1989) Cardiovascular manifestations of acute neurological lesions. In: Aminoff MJ (ed) Neurology and general medicine. Churchill Livingstone, New York, pp 159–167

    Google Scholar 

  22. Pasztor E, Fedina N, Kocsis B, Berta Z (1986) Activity of peripheral sympathetic efferent nerves in experimental subarachnoid haemorrhage. Acta Neurochir (Wien) 79: 125–131

    Google Scholar 

  23. Stober T, Kunze K (1982) Electrocardiographic alterations in subarachnoid haemorrhage. J Neurol 227: 99–113

    PubMed  Google Scholar 

  24. Walter P, Neil-Dwyer G, Cruickshank JM (1982) Beneficial effects of adrenergic blockade in patients with subarachnoid haemorrhage. Br Med J 284: 1661–1664

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of the Saarland, Homburg, Saar, Federal Republic of Germany

    G. Hamann, A. Haass & K. Schimrigk

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  1. G. Hamann
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  2. A. Haass
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  3. K. Schimrigk
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Hamann, G., Haass, A. & Schimrigk, K. Beta-blockade in acute aneurysmal subarachnoid haemorrhage. Acta neurochir 121, 119–122 (1993). https://doi.org/10.1007/BF01809261

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