Research On Cerebral Vasospasm Prevention And Treatment With Intracisternal Nimodipine

Objective:To investigate the effect of intracisternal nimodipine therapy on cerebral vasospasm in the rabbit double subarachnoid hemorrhage model.Methods:New Zealand White rabbits were randomly assigned to third groups:the control sham-operated group, the control subarachnoid hemorrhage group (n=14),and the treatment group (n=14) receiving 0.5ml (twice a day) of intracisternal nimodipine(10mg/50ml) for 4 days via implanted catheter. The consciousness, spontaneous activity and ingestion were observed before and after SAH. Vasospasm was analyzed pre-operation and 5 days later (D5)by means of digital subtraction angiography.Results:The neurological deficit,ingestion and vasospasm were not found with all animals at pre-operation.There was no significant difference between the neurological scores;spontaneous activity, ingestion decreased and listlessness after the first blood injection in the rabbits, some rabbits may have stiff-neck. Symptoms increased significantly after double injection of blood.the rabbits can not look for food initiatively, the eye tremor levely, difficulty walking, paralysis or quadriplegia. Compared with the SAH group, animals treated with nimodipine showed a better functional outcome with a significant improvement in neurological score (P<0.05).The existence of cerebral vasospasm was confirmed by DSA in the SAH group and the treatment group.There was no difference in control group from pre-operation to D5 (P>0.05).Intrathecal injection of nimodipine prevented SAH-induced CVS.There was significant prevention of CVS in animals treated with nimodipine(the treatment group:87.37%±5.71%,n=12 vs the SAH group:74.71%±7.96%n=12,P<0.05).Conclusion:1,The model of SAH induced by the double injections of blood into the cisterna magna is ideal.The dural was exposed in order to avoid damaging the brain stem. Its localization accuracy and the success rate is high. It can achieve the purpose of the research.2,Vasospasm of rabbits were evaluated by selectively angiography of vertebral artery.It can effectively determine the degree of vascular spasm. It provides an objective indexes.3,Intracisternal nimodipine infusion with 0.5 ml(twice a day), leads to significant arterial relaxation of cerebral vasospasm in the rabbit double subarachnoid hemorrhage model.It maybe an effective durg delivered route.