In six subarachnoid hemorrhage cases due to ruptured anerysm, effects of cisternal administration of Nicardipine hydrochloride (nicardipine) on vasospasm were studied. Nicardipine was one of Ca antagonists. All aneurysms were clipped within 48 hours after the onset of subarachnoid hemorrhage with ventricular and cisternal drainages. Subarachnoid clot was removed as much as possible.
Nicardipine or mixture of nicardipine and urokinase was administered through cisternal drainage every day for 10 days postoperatively. The dose of nicardipine was 2 mg or 4 mg, and that of urokinase was 6,000 units or 24,000 units. In two cases cisternal drainages were slipped out naturally on 9th and 6th day postoperatively, so further administration of nicardipine was not possible.
On the 7th day after the onset of subarachnoid hemorrhage, angiography was performed two times before and 30 minutes after cisternal administration of nicardipine. Then the diameters of vessels were compared each other in order to estimate the vasodilative effect of nicardipine.
In almost all cases vasodilative effect of nicardipine could not be observed whether vasospasm occurred or not. But this did not always point out this drug to be ineffective. In this study nicardipine was considered to have some prophylactic effects to vasospasm because vasospasm was not observed either angiographically or clinically in 2 of 3 severe subarachnoid hemorrhage cases on CT, the outcomes of those cases were estimated as good recovery.
