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Cerebral Vasospasm after Subarachnoid Hemorrhage and Tadalafil-Nimodipine Hypothesis
Abstract
Cerebral vasospasm following subarachnoid hemorrhage (SAH) is a common reaction induced by multiple factors with unclear mechanisms. This complication is difficult to treat and puts patient at risk for developing a delayed ischemic neurological deficit that can lead to substantial morbidity and mortality. Although numerous strategies have been suggested for the treatment and prevention of cerebral vasospasm following SAH, no definitive effect has been concluded in this regard. In this paper, we hypothesize that phosphodiesterase-5 inhibitors, tadalafil, can be used together with nimodipine, a calcium channel blocker, to prevent vasospasm in patients with subarachnoid hemorrhage. With synergic effects, the proposed drugs can promote relaxation of smooth muscles in spastic vessels.
Keywords: Cerebral vasospasm; nimodipine; phosphodiesterase-5 inhibitor; subarachnoid hemorrhage; tadalafil
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Kassell NF, Sasaki T, Colohan AR, Nazar G. Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke. 1985;16:562-572.
Kassell NF, Torner JC, Haley EC Jr, Jane JA, Adams HP, Kongable GL. The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results. J Neurosurg. 1990;73:18-36.
Macdonald RL, Weir BK. A review of hemoglobin and the pathogenesis of cerebral vasospasm. Stroke. 1991;22:971-982.
Sano K, Asano T, Tanishima T, Sasaki T. Lipid peroxidation as a cause of cerebral vasospasm. Neurol Res. 1980;2:253-272.
Sasaki T, Wakai S, Asano T, Watanabe T, Kirino T, Sano K. The effect of a lipid hydroperoxide of arachidonic acid on the canine basilar artery. An experimental study on cerebral vasospasm. J Neurosurg. 1981;54:357-365.
Chyatte D. Anti-inflammatory agents and cerebral vasospasm. Neurosurg Clin N Am. 1990;1:433-450.
Handa Y, Kubota T, Kaneko M, Tsuchida A, Kobayashi H, Kawano H, Kubota T. Expression of intercellular adhesion molecule 1 (ICAM-1) on the cerebral artery following subarachnoid haemorrhage in rats. Acta Neurochir (Wien). 1995;132:92-97.
Dorsch NW. Cerebral arterial spasm--a clinical review. Br J Neurosurg. 1995;9:403-412.
Edvinsson L, Alafaci C, Delgado T, Ekman R, Jansen I, Svendgaard NA, Uddman R. Neuropeptide Y and vasoactive intestinal peptide in experimental subarachnoid hemorrhage: immunocytochemistry, radioimmunoassay and pharmacology. Acta Neurol Scand. 1991;83:103-109.
Edwards RM, Stack EJ, Trizna W. Calcitonin gene-related peptide stimulates adenylate cyclase and relaxes intracerebral arterioles. J Pharmacol Exp Ther. 1991;257:1020-1024.
Faraci FM, Brian JE Jr. Nitric oxide and the cerebral circulation. Stroke. 1994;25:692-703.
Birk S, Edvinsson L, Olesen J, Kruuse C. Analysis of the effects of phosphodiesterase type 3 and 4 inhibitors in cerebral arteries. Eur J Pharmacol. 2004;489:93-100.
Pluta RM. Delayed cerebral vasospasm and nitric oxide: review, new hypothesis, and proposed treatment. Pharmacol Ther. 2005;105:23-56.
Sehba FA, Schwartz AY, Chereshnev I, Bederson JB. Acute decrease in cerebral nitric oxide levels after subarachnoid hemorrhage. J Cereb Blood Flow Metab. 2000;20:604-611.
Bilginer B, Onal MB, Narin F, Soylemezoglu F, Ziyal IM, Ozgen T. The effects of intravenous cilostazol and nimodipine on cerebral vasospasm after subarachnoid hemorrhage in an experimental rabbit model. Turk Neurosurg. 2009;19:374-379.
Rybalkin SD, Bornfeldt KE, Sonnenburg WK, Rybalkina IG, Kwak KS, Hanson K, Krebs EG, Beavo JA. Calmodulin-stimulated cyclic nucleotide phosphodiesterase (PDE1C) is induced in human arterial smooth muscle cells of the synthetic, proliferative phenotype. J Clin Invest. 1997;100:2611-2621.
Sandner P, Kornfeld M, Ruan X, Arendshorst WJ, Kurtz A. Nitric oxide/cAMP interactions in the control of rat renal vascular resistance. Circ Res. 1999;84:186-192.
Stoclet J, Karavis T, Komas N, Lugnier C. Cyclic nucleotide phosphodiesterases as therapeutic targets in cardiovascular diseases. Invest Drugs. 1995;4:1081-1100.
Kruuse C, Rybalkin SD, Khurana TS, Jansen-Olesen I, Olesen J, Edvinsson L. The role of cGMP hydrolysing phosphodiesterases 1 and 5 in cerebral artery dilatation. Eur J Pharmacol. 2001;420:55-65.
Giordano D, De Stefano ME, Citro G, Modica A, Giorgi M. Expression of cGMP-binding cGMP-specific phosphodiesterase (PDE5) in mouse tissues and cell lines using an antibody against the enzyme amino-terminal domain. Biochim Biophys Acta. 2001;1539:16-27.
Giorgi M, Squitti R, Bonsi P, Paggi P, Toschi G. Activities of 3':5' cyclic nucleotide phosphodiesterases in the superior cervical ganglion of rat: characterization, compartmentalization and observations in young and old animals. Neurochem Int. 1994;25:493-500.
Lorberboym M, Mena I, Wainstein J, Boaz M, Lampl Y. The effect of sildenafil citrate (Viagra) on cerebral blood flow in patients with cerebrovascular risk factors. Acta Neurol Scand. 2010;121:370-376.
Zhang R, Wang Y, Zhang L, Zhang Z, Tsang W, Lu M, Zhang L, Chopp M. Sildenafil (Viagra) induces neurogenesis and promotes functional recovery after stroke in rats. Stroke. 2002;33:2675-2680.
Koktekir E, Erdem Y, Akif Bayar M, Gokcek C, Karatay M, Kilic C. A new approach to the treatment of cerebral vasospasm: the angiographic effects of tadalafil on experimental vasospasm. Acta Neurochir (Wien). 2010;152:463-469.
Firat MM, Gelebek V, Orer HS, Belen D, Firat AK, Balkanci F. Selective intraarterial nimodipine treatment in an experimental subarachnoid hemorrhage model. AJNR Am J Neuroradiol. 2005;26:1357-1362.
Hänggi D, Turowski B, Beseoglu K, Yong M, Steiger HJ. Intra-arterial nimodipine for severe cerebral vasospasm after aneurysmal subarachnoid hemorrhage: influence on clinical course and cerebral perfusion. AJNR Am J Neuroradiol. 2008;29:1053-1060.
Dorhout Mees SM, Rinkel GJ, Feigin VL, Algra A, van den Bergh WM, Vermeulen M, van Gijn J. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2007;(3):CD000277.
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