Abstract
Background : Cerebral vasospasm(VS)is a major cause of neurological deterioration in patients with subarachnoid hemorrhage(SAH). Previous studies have shown a markedly high level of thrombin activity in the cerebrospinal fluid(CSF)of patients with SAH. This study was undertaken to confirm that previously reported correlation between VS and thrombin, by administering the thrombin-inhibitor"argatroban". Methods : Adult mongrel dogs received autogenous arterial blood injections in the cisterna magna(0.5ml/kg), and were given continuous intrathecal infusion of argatroban using osmotic pump(argatroban group). As controls, other dogs received ringer's solution alone. Angiography was performed before surgery and again, seven days after the treatment. Histological evaluation of the blood vessels and inflammatory cells in the subarachnoid space was performed on day seven. Results : The mean diameter of the basilar artery on day seven was significantly larger in the argatroban group(p=0.0191). There were also fewer inflammatory cells in the subarachnoid space in argatroban group(p=0.0079). Conclusion : Thrombin plays an important role in the mechanism of VS following SAH, and its inhibition may open a therapeutic window to VS.
