1991 Volume 19 Issue 2 Pages 262-268
The effect of combined therapy of Ozagrel Na and Nizofenone on delayed ischemic neurological deficits (DIND) following subarachnoid hemorrhage (SAH) due to aneurysmal rupture was investigated.
A consecutive series of 50 individuals with SAH subjected to early operation (within 72 hours after the recent attack) were categorized in 3 treatment groups.
All patients were admitted to one institution and operated on by the senior author (T. T.) between January, 1987, and September, 1989. Patients were divided into three groups according to treatment protocol: treated by ordinary therapeutic method (20 cases=group A), treated with intravenous administration of Ozagrel Na, 80mg/day for 14 days after the clipping operation (13 cases=group B) and treated with same dosage of Ozagrel Na and Nizofenone, 30mg/day for 14 days after the operation (17 cases=group C).
Location of ruptured aneurysm, neurological grade and CT classification of the patients on admission were the same in all three groups. Overall outcome by Glagow Outcome Scale at discharge was as follows: in 20 cases of group A, Good Recovery (GR): 13 cases (65.0%), Moderately Disabled (MD): 5 cases (25.0%), Dead (D): 2 cases (10.0%), in 13 cases of group B, GR: 4 cases (30.8%), MD: 3 cases (23.1%), Severely Disabled (SD): 2 cases (15.4%), D: 4 cases (30.8%) and in 17 cases of group C, GR: 12 cases (70.6%), MD: 3 cases (17.6%), SD: 1 case (5.9%), Vegetative Survival (VS): 1 case (5.9%).
Among 41 patients who were in Hunt and Kosnik grade I through III, 9 cases (50%) of group A, 4 cases (40%) of group B and 5 cases (38.5%) of group C showed DIND in the postoperative course. In those patients DIND remained as a permanent neurological dysfunction in 5 cases (27.8%) of group A, 3 cases (30.0%) of group B and 2 cases (15.4%) of group C consequently. Thus group C patients treated with Ozagrel Na and Nizofenone showed better outcome.
Nizofenone, a protective agent for the brain, may be useful as a therapy for delayed neurological deficits following SAH.
