Abstract
Prevention of delated ischemic neurological deficits (DIND) following subarachnoid hemorrhage (SAH) has been tried by the surgical removal of subarachnoid hematoma as much as possible during the operation and continuous drainage of the cerebral ventricle and cistern postoperatively. Concomitant pharmacotherapies with administration of mannitol, glyceol, steroid, nizophenon, low-molecular dextran, barbital, Ca++ antagonists, or antithrombocyte agents as well as management of Hypervolemia and Hypertension have been used and the clinical outcome is generally improving. In spite of the above treatments, however, prognosis is still infavorable in some cases. Delayed vasospasm is thought to be caused by an angiospastic substance produced in the course of decomposition of the shed blood. We administered urinastatin and gebaxate medilate, polyvalent anti-enzymatic agents, immediately after SAH and our clinical observation has led to the impression that the treatment could prevent DIND in the patients.
