Treatment of cerebral vasospasm with intra-arterial fasudil hydrochloride

OBJECTIVE: Symptomatic cerebral vasospasm, is a major cause of disability and death in patients with aneurysmal subarachnoid hemorrhage. The purpose of this study was to determine the efficacy of intra-arterial infusion (IAF) of fasudil hydrochloride for symptomatic vasospasm in terms of neurological improvement and the angiographic features of cerebral vessels. METHODS: A consecutive series of 23 patients underwent IAF therapy for the treatment of symptomatic vasospasm after subarachnoid hemorrhage. Angiographic vasospasm was assessed before and after-the IAF treatment. Immediate clinical effect was assessed within 24 hour's after the IAF treatment, and the Glasgow Outcome Scale was used to evaluate late clinical outcome at 3 months after the onset. RESULTS: IAF treatment was performed on 34 occasions for 23 patients (1.6 women, 7 men. Angiographic improvement was observed on all occasions (100%), and immediate clinical improvement was, -observed: on 15 occasions (44.1%). At 3-month follow-up, 15 patients (65.2%) showed good recovery or moderate-disability on the Glasgow Outcome Scale. CONCLUSION: IAF therapy was effective in dilating spastic arteries, and clinical improvement was:observedin-approximately asudil, hydrochloride infusions. Our findings suggested that the IAF therapy was safe and effective for patients with symptomatic vasospasm after subarachnoid hemorrhage.