J Korean Neurosurg Soc.  1983 Mar;12(1):83-93.

Induced Hypertension Therapy for Postoperative Cerebral Ischemia in Aneurysm Surgery

• Kang JK
• Paik MW
• Kim MC
• Kang SK
• Kim DS
• Ha YS
• Song JU

Abstract

The purpose of this study is to clarify the effectiveness and the indications of the dopamine induced hypertension therapy(IHT) in the treatment of symptomatic cerebral ischemia secondary to aneurysm surgery. Eight patients suffering from ischemic complication of postoperative vasospasm were treated with dopamine induced hypertension therapy and intravascular volume expansion. All of patients underwent CT scan in order to ascertain if their neurological deteriorations were due to vasospasm. The criteria of the indication of IHT are as follows : 1) ischemic symptoms were progressively advanced, 2) there is no hematoma or infarction on CT scan, 3) there is no responses to ischemic symptoms with hyperventilation, intravascular volume expansion, 4) there is no hypovolemia. The blood pressure was raised to 30% above the mean arterial pressure that required for reversal of the ischemic deficit with dopamine induced hypertension and increasing the intravascular volume. In seven of eight patient, a marked improvement in ischemic symptoms occurred after raising blood pressure, and blood volume. In 4 cases, the level of consciousness and neurological deficits were improved within 12 hours after IHT started. IHT is expected to restore the brain tissue from ischemia by increasing blood flow through the arteries of vasospasm and collateral circulation.

Keyword

Cerebral ischemia; Cerebral vasospasm; Intracranial aneurysms; Dopamine induced hypertension; Intravascular volume expansion

MeSH Terms

Aneurysm*
Arterial Pressure
Arteries
Blood Pressure
Blood Volume
Brain
Brain Ischemia*
Collateral Circulation
Consciousness
Dopamine
Hematoma
Humans
Hypertension*
Hyperventilation
Hypovolemia
Infarction
Intracranial Aneurysm
Ischemia
Tomography, X-Ray Computed
Vasospasm, Intracranial
Dopamine