Trasylol and Dexamethasone Therapy for Hydrocephalus after Experimental Subarachnoid Hemorrhage.

Kim, Kwang Myung; Chung, Hwan Yung

Original Article

Journal of Korean Neurosurgical Society 1975;4(2): 277-284.

Department of Neurosurgery, Hanyang University, School of Medicine, Seoul, Korea.

ABSTRACT

Hydrocephalus was reported to occur in man in approximately 35% of subarachnoid hemorrhage and shunting procedure was inevitable in about one third of them. This study was planned to explore the possibility of preventing the evolution of hydrocephalus after subarachnoid hemorrhage by Trasylol or dexamathasone therapy. A total of eighty-seven rabbits weighing 3kg were used. Three times of cisternal injections of 0.15 ml of blood were performed at every other day. Seventeen rabbits died of initial technical failure at the time of the first cisternal injection of blood. The remaining seventy rabbits were divided into four groups;Group I(20 rabbits) was of control group, Group II(10 rabbits) received three cisternal injection of 5,000 KIU of Trasylol at the time of cisternal blood injection, Group III(20 rabbits) received intravenous injection of 2,000 KIU of Trasylol four times daily for 10 days, and Group IV(20 rabbits) was treated with intramuscular injection of dexamethasone which was gradually tapered for 10 days. All the rabbits were sacrified three weeks later the last cisternal injection of blood. Their heads were sectioned and ventricular measurement was made. Trasylol and dexamethasone reduced the incidence of hydrocephalus from 31% to 43% while 81% in control group. The mortality rate after subarachnoid hemorrhage was also remarkably reduced in the treated groups. A reduction in post-SAH hydrocephalus can be achieved by Trasylol and dexamethasone. It seems to be by their anti-inflammatory effects.