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Cerebral vasospasm following subarachnoid hemorrhage--experimental and clinical studies.

Delayed cerebral vasospasm was studied in exposed basilar arteries 3days after cisternal injection of blood in cats. Substances containing heme components such as oxyhemo globin, methemoglobin, catalase, NADH and methemalbumin, induced profound vaso spasm when applied topically. All products released from erythrocytes with heme components may be responsible for delayed cerebral vasospasm. Vasospasm produced by incubated blood-CSF mixture was relieved by topical application of fusaric acid, methylprednisolone, salbutamol, -phenanthroline or ascorbic a id. Levels of cyclic AMP in cerebral vessels were slightly increased after cisternal injection ofascorbic a id (100 mg), as well as aminophylline (25mg). Patients with vasospasm following subarachnoid hemorrhage were treated with intra thecal administration of ascorbic acid (200-1,000 mg). Of 5 treatment trials, there were 2 definite beneficial responses. Certain improvements were obtained in patients who were treated with ascorbic acid within 16 hours after the onset of symptoms.