Treatment of Cerebral Vasospasm by Topical Application of Lidocaine

Abstract

This paper reports the treatment of cerebral vasospasm by topical application of lidocaine in 3 patients with ruptured aneurysm. Each case had shown vasospasm of the smooth narrowing type on preoperative angiogram performed on the 9th day after the subarachnoid hemorrhage attack. Direct aneurysmal operation was carried out on the 9th day in I case and on the 10th day in 2 cases. After clipping of the aneurysm, subarachnoid clot was removed and cottonoids soaked in 1-4% of lidocaine was applied over the spastic arteries. After 10-15 minutes, the vessels showed marked dilatation in each instance. Postoperative angiograms also showed relief of the spasm of the arteries which had been in contact with lidocaine during the operation.
Pharmacological basis of spasmolytic action of lidocaine and its indication for clinical use are discussed.