Experimetal Study Of Intraarterial Different Doses Nimodipine Infusion In Treating Cerebral Vasospasm Following Subarachnoid Hemorrhage

Objective: Cerebral vasospasm(CVS) following subarachnoid hemorrhage(SAH) is a major cause of high mortality and morbitidy for those experiencing the rupture of intracranial aneurysm, and it often induces ischemic neurological deficits. but its ture mechanism secondary impairment still remain unclear, and there is no effective method to prevent and treat CVS. Lots of clinical and experimental studies have showd that"calcium over loading"is one important cause of cerebral vasospasm following subarachnoid hemorrhage. Antagon of calcium一nimodipine, with the effect of vessels--dilation and neuroprotection is effective in preventing cerebral vasospasm following subarachnoid hemorrhage. In the present study we assessed the anti--CVS effect of intraarterial infusion nimodipine and choosed appropriate doses of nimodpine in a rabbit mode1 of subarachnoid hemorrhage.Method: CVS model was established by using"double subrachnoid hemohrrage, Which injecting arterial blood twice through the citerna magna 48 hours apart,1 millilter each time. Eighty rabbits were equally randomized to four groups,there are twenty rabbits in each group. Three of all were treated by using intraarterial infusion different doses of nimodipine, the other is control group with infusing physiological saline . we observed the behavior changes, moprhological changes and the result of selective angiography of the vertebral artery.Result: Nerve function of the rabbits of nimodipine group were better obviously than the rabbits of control group. The middle and high doses nimodipine groups have marked efficiency than the low doses nimodipine group in preventing CVS of SAH(P<0.05). Both of middle and high doses nimodipine groups have not apparently different in preventing CVS of SAH. The pathological study revealed that the selective arterial perfusion of nimodipine could reduce the apoptosis of cerebral nerve induced by CVS.Conclusion: Selective vertebral arterial perfusion of nimodipine could greatly resolve the CVS both clinically and pathologically. The middle doses nimodipine is best.