EFFECT OF INTRAARTERIAL PAPAVERINE ON CEREBRAL-CIRCULATION TIME

PURPOSE: To measure the mean cerebral circulation time (CCT) in patien ts with symptomatic vasospasm stemming from subarachnoid hemorrhage an d to determine any change after papaverine treatment. METHODS: We stud ied 27 patients who received intraarterial papaverine from November 19 92 to August 1995 to determine the CCT in 59 carotid territories. CCT was measured from the first image in which contrast was seen above the supraclinoid internal carotid artery to the peak filling of parietal cortical veins, Angiograms at the time of presentation were examined i n 19 of the 27 patients. A control population of 19 patients (30 carot id territories) was also studied. RESULTS: The mean CCT on presentatio n was 6.8 seconds +/-1.1. The prepapaverine mean CCT was 6.1 seconds /- 1.2. The immediate postpapaverine mean CCT was 3.8 seconds +/- 0.8. CCT decreased in 58 of 59 territories treated with papaverine; the me an change was -35.7%. In eight of these patients, CCT rose on the foll owing day to 6.1 seconds +/- 1.1. In the control group, mean CCT was 5 .9 seconds +/- 0.8. The mean CCT in patients with subarachnoid hemorrh age was slightly prolonged on presentation relative to that in control subjects. CONCLUSION: Intraarterial papaverine produces a consistent decrease in CCT in patients with vasospasm.