BACKGROUND: Intravenous dantrolene has been used to prevent and treat cerebral vasospasm. We report a case of refractory cerebral vasospasm treated with intra-arterial dantrolene after aneurysmal subarachnoid hemorrhage. METHODS: A 56-year-old woman suffered a diffuse subarachnoid hemorrhage from a ruptured anterior communicating artery aneurysm which was successfully treated with coil embolization. She subsequently developed bilateral severe angiographic vasospasm which was treated with intra-arterial vasodilators. However, owing to the recurrence of vasospasm, intra-arterial dantrolene followed by balloon angioplasty was used. RESULTS: There was moderate improvement of the severe vasospasm in bilateral A1 segments of the anterior cerebral arteries after microcatheter-based intra-arterial infusion of 30 ml (1 mg/ml) dantrolene. Patient's hemodynamic parameters were monitored during and after the procedure and no significant changes were seen after dantrolene infusion. A follow up cerebral angiogram after 1 day demonstrated the persistence of therapeutic effect. CONCLUSION: Intra-arterial dantrolene induced a sustained improvement in cerebral vasospasm secondary to ruptured aneurysm. No significant side effects were observed during or after the infusion of the drug.
BACKGROUND: Intravenous dantrolene has been used to prevent and treat cerebral vasospasm. We report a case of refractory cerebral vasospasm treated with intra-arterial dantrolene after aneurysmal subarachnoid hemorrhage. METHODS: A 56-year-old woman suffered a diffuse subarachnoid hemorrhage from a ruptured anterior communicating artery aneurysm which was successfully treated with coil embolization. She subsequently developed bilateral severe angiographic vasospasm which was treated with intra-arterial vasodilators. However, owing to the recurrence of vasospasm, intra-arterial dantrolene followed by balloon angioplasty was used. RESULTS: There was moderate improvement of the severe vasospasm in bilateral A1 segments of the anterior cerebral arteries after microcatheter-based intra-arterial infusion of 30 ml (1 mg/ml) dantrolene. Patient's hemodynamic parameters were monitored during and after the procedure and no significant changes were seen after dantrolene infusion. A follow up cerebral angiogram after 1 day demonstrated the persistence of therapeutic effect. CONCLUSION: Intra-arterial dantrolene induced a sustained improvement in cerebral vasospasm secondary to ruptured aneurysm. No significant side effects were observed during or after the infusion of the drug.
Authors: Qaisar A Shah; Muhammad Zeeshan Memon; M Fareed K Suri; Gustavo J Rodriguez; Osman S Kozak; Robert A Taylor; Ramachandra P Tummala; Gabriela Vazquez; Alexandros L Georgiadis; Adnan I Qureshi Journal: Neurocrit Care Date: 2009-04-16 Impact factor: 3.210
Authors: G S Allen; H S Ahn; T J Preziosi; R Battye; S C Boone; S C Boone; S N Chou; D L Kelly; B K Weir; R A Crabbe; P J Lavik; S B Rosenbloom; F C Dorsey; C R Ingram; D E Mellits; L A Bertsch; D P Boisvert; M B Hundley; R K Johnson; J A Strom; C R Transou Journal: N Engl J Med Date: 1983-03-17 Impact factor: 91.245
Authors: Christian Burrell; Nicole E Avalon; Jason Siegel; Michael Pizzi; Tumpa Dutta; M Cristine Charlesworth; William D Freeman Journal: Expert Rev Neurother Date: 2016-07-11 Impact factor: 4.618