TREATMENT OF CEREBRAL VASOSPASM WITH INTRATHECAL NITRIC OXIDE DONORS

ABSTRACT

Cerebral vasospasm remains a formidable obstacle to the recovery of patients surviving aneurysmal subarachnoid hemorrhage. Its mechanisms appear to be complex and knowledge of them is incomplete, resulting in relatively indirect and often ineffective treatments. Particularly acknowledged is the occurrence of vasospasm in smaller-caliber resistance vessels, capable of causing significant neurological dysfunction yet not easily detectable by transcranial Doppler examination or cerebral angiography. Therapeutic options for this type of vasospasm are very limited. Molecular-level investigations in recent years have shed some light upon possible mechanisms of vasospasm that may be amenable to therapeutic intervention by manipulation. The introduction of the nitric oxide molecule to the adventitial microenvironment through intrathecal administration is one such manipulation based on hypothesis-driven research; it has recently been introduced to the clinical setting by the author and is the subject of this report.

KEYWORD

Cerebral vasospasm - human - nitric oxide

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