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Journal of Korean Neurosurgical Society > Volume 6(1); 1977 > Article
Journal of Korean Neurosurgical Society 1977;6(1): 19-28.
Treatment of Cerebral vasospasm before after Intracranial Aneurysmal Surgery: Experience with the use of Isoproterenol and Lidocaine Hydrochloride.
Eui Wha Chung, Young Soo Kim, Kyu Chang Lee, Hun Jae Lee
1Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea.
2Department of Neurosurgery, Yonsei University Medical Center, Seoul, Korea.
The cerebral vasospasm which often accompanies a subarachnoid hemorrhage from a ruptured intracranial aneurysm is one the chief reasons for morbidity and motarlity. Although the phenomenon still needs clarification, experimental evidence has indicated that alpha-blocking agents can modify this blood-induced spasm. A disappointing experience with these agents led to a clinical trial of the beta-adrenergic drug isoproterenol. In 1975 Sundt reported a good final result with the use of isoproterenol and lidocaine hydrochloride in the treatment of cerebral ischemia attributed to progressive vasospasm after a subarachnoid hemorrhage in human beings. We have reported our experience with the use of isoproterenol and lidocaine hydrochloride in 5 such cases. 3 were treated preoperatively and 2 postoperatively. Experience suggests that the drug regimen reported is useful when institute early after the onset of symptoms and is safe with proper monitoring techniques. The symptomatology of cerebral vasospasm, the reationable for this form of therapy, and the pharmacology of the drugs were discussed.
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