Objective:

To investigate the intraarterial papaverine treatment efficacy of aneurysmal subarachnoidal hemorrhage (SAH) related vasospasm (VS).

Material and Methods:

We evaluated 149 aneurysmal subarachnoidal hemorrhage patients medical records retrospectively, who were performed endovascular coilization or surgically clipping operation. In these patients, 22 patients were developed vasospasm, and treated with intraarterial papaverine. We investigated the radiologic parameters of arterial dilatation during the VS and after papaverine injection on anjiography. Also the aneurysmal SAH predictive factors of patients were investigated.

Results:

There were 10 male and 12 female patients, the main age was 52.41±10.98. There were 10 anterior communicating artery aneurysms, 10 middle cerebral artery aneurysms, 1 posterior communicating artery aneurysm and 1 internal carotid artery aneurysm in patients. We performed endovascular treatment to 19 patients and surgery to 3 patients. We showed the vasospasm in all patients angiographically. There are 15 left hemispheric infarcts and 7 right hemispheric infarcts. The mean A1 segment anterior cerebral artery diameter was 1.31±0.49 mm during VS and increased to 1.85±0.51 mm after intraarterial papaverine treatment (p<0.0001). The mean M1 segment middle cerebral artery diameter was 2.01±0.54 mm during VS, and increased to 2.73±0.42 mm after treatment (p<0.0001).

Conclusion:

In our study, we investigate the effect of intraarterial papaverine treatment after aneurysmal SAH related VS and we showed significant increase in arterial diameters after treatment.

Keywords: papaverine, vasospasm, aneurysm, endovascular treatment, aneurysm surgery