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KMID : 1141120180040020077
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The Nerve
2018 Volume.4 No. 2 p.77 ~ p.81
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Effect on Ischemia of Nicardipine Hydrochloride in Acute Intracerebral Hemorrhage: Perfusion Computed Tomography Study
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Jeong Do-Kyeun
Hwang Sung-Kyun
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Abstract
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Objective: We performed brain perfusion computed tomography (CT) studies to correlate the effect of intravenous nicardipine hydrochloride (HCl) with ischemia around the hematoma in patients with intracerebral hemorrhage (ICH).
Method: Thirty-two patients (mean age±range, 60±11.5 years) with hypertensive ICH who visited a single center from March 2013 to December 2015 were treated with intravenous injection of nicardipine HCl. Cerebral blood flow (CBF), maximum oxygen extraction fraction (OEFmax) and maximum cerebral metabolic rate of oxygen (CMRO2max) were measured by the brain perfusion CT to determine if there is any ischemia around the hematoma and the contralateral normal site at the time of admission and after 24 hr twice.
Results: Perihematoma data were compared with mirror contralateral normal region. Systolic blood pressure (BP) and diastolic BP were significantly decreased after nicardipine administration, and perihematoma CBF was not significant different from that of the normal contral lateral site after 24 hr from admission. Mean OEFmax slightly was higher in the perilesional area than in the contralateral normal area and CMRO2max of perilesional area was slightly lower than that of the contralateral area. But there were no significant changes between the two groups.
Conclusion: This study suggests that lowering BP using nicardipine after ICH does not show significant changes in CBF, OEFmax, and CMRO2max measured by perfusion brain CT. Based on this, it is possible to support the controlled use of intravenous nicardipine HCl at acute phase of hypertensive ICH. Large-scale controlled studies, long-term results are needed to evaluate the actual effect of the ischemic changes around the hematoma when using this drug to lower BP.
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KEYWORD
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ebral hemorrhage, Cerebrovascular circulation, Nicardipine, Perfusion imaging, Tomography, X-ray computed
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