J.Jpn. Surg. Soc.. 78(4): 359-375, 1977

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Original article

EXPERIMENTAL AND CLINICAL STUDIES OF TREATMENT FOR PROLONGED VASOSPASM

Cerebral arterial spasm following SAH is one of the most important problem for the treatment of the ruptured aneurysm. And most neurosurgeons will agree that it can result in ischemic complications and even cerebral infarction. However, at present, its etiology has not been fully understood and essentially there is no effective treatment for this condition. Recently, in our study, biochemical analysis of spasmogenic substances released from blood were performed. As the result, oxyhemoglobin (oxy-Hb) or its allied polypeptide which has been produced by hemolysis of extravasated red blood cells is mainly causative substance for prolonged spasm. In this study, oxy-Hb. and arterial fresh blood were applied to both in vitro and in vivo experiments, and prolonged vasospasm was produced by these substances. And moreover, author carried out to search for the substances which can release vasospasm. Haptoglobin (Hp) which is normal constituent of the serum, is known to combine with Hb. to form a chemically stable Hb-Hp. compound. The vasospasm which was produced by oxy-Hb. or the arterial fresh blood, was released by the addition of Hp. both in vitro and in vivo experiments. Based on these experimental findings, clinical use of Hp. on the vasospasm was made in 18 cases. In 11 cases, the angiographical spasm was progressively increased or decreased at the previous day before the surgery. And these 10 of 11 cases showed angiographical improvement of vasospasm after clinical use of Hp. Thus the beneficial effects of Hp. seems to be obvious to these cases which showed fluctuated findings of angiographical spasm. I considered that application of Hp. is one of the effective method for the treatment of vasospasm.

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