Intra-arterial infusion of fasudil hydrochloride for treating vasospasm following subarachnoid haemorrhage

In this pilot study we treated cerebral vasospasm in patients with subarach noid haemorrhage to assess intra-arterial fasudil hydrochloride. We analyse d effects of intra-arterial infusion on angiographically evident cerebral v asospasm in 10 patients including 3 with symptoms of vasospasm. Over 10 to 30 min 15 to 60 mg was administered via the proximal internal carotid arter y or vertebral artery following standard angiography, without superselectiv e techniques. A total of 24 arterial territories (21 internal carotid, 3 ve rtebral) were treated. Angiographic improvement of vasospasm was demonstrat ed in 16 arterial territories (local dilation in 2, diffuse dilation in 14) in 9 patients. In 2 symptomatic patients, intra-arterial fasudil hydrochlo ride was associated with resolution of symptoms without sequelae. In the th ird symptomatic patient the benefit of fasudil hydrochloride was only tempo rary, and a large cerebral infarction occurred. All asymptomatic patients s howed no progression of angiographic to symptomatic vasospasm after treatme nt with intra-arterial fasudil hydrochloride. No adverse effect was encount ered.