Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-6608
Platz, J; Baráth, K; Keller, E; Valavanis, A (2008). Disruption of the blood-brain barrier by intra-arterial administration of papaverine: a technical note. Neuroradiology, 50(12):1035-1039.
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INTRODUCTION: Various endovascular techniques can be used to treat cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH) including intra-arterial administration of vasodilator drugs such as papaverine or nicardipine and balloon dilatation of the affected vessel segment. Papaverine is known to have side effects, and we report a possible new one.
MATERIALS AND METHODS: After the treatment of cerebral vasospasm in a SAH patient by intra-arterial administration of papaverine into the left posterior cerebral artery, severe mesencephalic extravasation of blood and contrast media was detected.
RESULTS: After reviewing the literature, the authors conclude that interruption of the blood-brain barrier by papaverine most likely combined with a secondary hyperperfusion phenomena, and perhaps a direct toxic effect on brain tissue was the mechanism of this major complication.
CONCLUSION: In treating vasospasm in areas with a high density of perforating arteries, especially in the posterior circulation, papaverine should be used cautiously because a safe regimen has yet to be established. In this situation, alternative agents such as calcium channel blockers could be considered, but evidence-based data are still missing.
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|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Clinic for Neuroradiology|
|Dewey Decimal Classification:||610 Medicine & health|
|Deposited On:||12 Dec 2008 09:32|
|Last Modified:||05 Apr 2016 12:37|
|Additional Information:||The original publication is available at www.springerlink.com|
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