Ca2＋拮抗剤（Diltiazem）の髄液腔内投与による脳血管攣縮寛解効果—動脈内投与との比較ならびに髄液腔内濃度の検討

Relief of Experimental Cerebral Vasospasm by an Intrathecal Administration of Calcium Antagonist (Diltiazem):In comparison with intra-arterial administration

I．はじめに

　脳動脈瘤破裂後のくも膜下出血によって発生する脳血管攣縮には，臨床上しばしば遭遇するが，その治療は困難で効果的な対策は見いだされていない．

　著者ら^{3,14,14,15）}は，脳血管平滑筋においても骨格筋と同様，収縮，弛緩の調節機序にCa^2＋が直接関与していることを明らかにし，Ca^2＋拮抗剤が実験的脳血管攣縮の寛解に効果があることを報告してきた．

The effect of an intra-arterial administration of diltiazem on experimental cerebral vasospasm was previously reported by us. In the present study, the effect of diltiazem on cerebral vasospasm, intracranial pressure and systemic blood pressure were investigated using dogs. Cerebral vasospasm was induced by an injection of 5 ml of autologous blood into the cisterna magna. Diltiazem (10-⁶M) was administrated into the cisterna magna and the dilating effect of the drug on the basilar artery was monitored angiographically.