PATHOPHYSIOLOGY OF CHRONIC CEREBRAL VASOSPASMS
慢性脑血管痉挛的病理生理学
基本信息
- 批准号:3411516
- 负责人:
- 金额:$ 12.32万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:1988
- 资助国家:美国
- 起止时间:1988-04-01 至 1991-03-31
- 项目状态:已结题
- 来源:
- 关键词:Macaca aneurysm angiography antithrombin III aspirin calcium channel blockers cardiovascular pharmacology cerebral ischemia /hypoxia cerebrovascular disorder diagnosis disease /disorder model drug metabolism electrical potential free radicals glucose metabolism heparin hyperoxia magnetic resonance imaging pathologic process prostacyclins ultrasound blood flow measurement vascular smooth muscle vasospasm
项目摘要
About 10 new cases of ruptured aneurysm per 100,000 population
may be anticipated each year. The average age of such patients
is just over 50 years. While 15 or 20 % of sufferers die instantly
the majority now survive to be hospitalized. If these patients do
not die of the initial disruptive effects of their hemorrhage they
then have to face a variety of life threatening delayed hazards
including most importantly delayed ischemia from chronic
vasospasm as well as rebleeding. It has been estimated that an
effective therapy for vasospasm could save 5,000 lives in North
America per year.
In the past decade there has been progress in the medical
management of the low blood flow resulting from the spasm of
the larger basal conducting arteries consequent to the surrounding
clot. Firstly, regional flow is increased by ensuring optimal
circulating blood volume, hematocrit, pressure, viscosity and
cardiac output. Secondly, neurological outcome has been
improved by the use of calcium antagonists which operate by a
mechanism other than the prevention of vasospasm in the large
conducting arteries-they may dilate smaller vessels or provide an
element of direct neuronal protection.
These developments have not however directly attacked the basic
problem of cerebral vasospasm. The pathophysiological chain of
events and its biochemical correlates are largely unknown so that
rational, direct therapy or prophylaxis is difficult. While
complete removal of the inciting blood clot wihin 48 hours
prevents vasospasm from developing in the primate model, total
removal is not possible in patients and vigorous attempts at this
carries additional surgical risks. A pharmacological intervention
to halt the chemical reactions which ultimately lead to a spastic
arterial segment would be preferable to the surgical prophylaxis if
it were without significant side effects such as systemic
hypotension.
It is proposed to characterize the chemical, pharmacological and
physiological changes associated with the development of chronic
vasospasm in a primate model using direct clot application to the
surgically exposed basal vessels sand sequential sampling of
arteries and brain tissue. Treatment strategies will be applied as
the mechanism is elucidated and as new and promising drugs and
delivery techniques are introduced.
每10万人中大约有10例动脉瘤破裂
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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BRYCE K WEIR其他文献
BRYCE K WEIR的其他文献
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{{ truncateString('BRYCE K WEIR', 18)}}的其他基金
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