In patients with hypertensive intracerebral hemorrhage, changes in regional cerebral blood flow (rCBF) following drug-induced blood pressure reduction were examined by SPECT. METHODS. The subjects were 68 patients with hypertensive intracerebral hemorrhage. The site of cerebral hemorrhage was the thalamus in 28 patients, and the putamen in 40 patients. RCBF was measured by SPECT using the 133Xe inhalation method. To reduce blood pressure, trimethaphan camsilate (an autonomic ganglion blocker) and diltiazem hydrochloride (a calcium antagonist) were used. RESULTS. 1. In the acute period, mean CBF declined as the mean arterial blood pressure declined by more than 20% in both the putaminal and the thalamic hemorrhage group (p < 0.01). 2. During the chronic period, a greater reduction in blood pressure was needed to induce mean CBF reduction. 3. Neither of the two drugs significantly reduced the mean arterial blood pressure, but the group receiving trimethaphan demonstrated a 7.9 approximately 7.5% decreased in CBF, group while the receiving diltiazem showed a 2.2 approximately 2.4% decrease (p < 0.05). CONCLUSIONS. In patients with hypertensive intracerebral hemorrhage, a 20% or more drug-induced decrease in blood pressure resulted in a decrease in mean CBF. During the acute period of intracerebral hemorrhage, blood pressure showed reduced by 20%. Clinically, diltiazem was more effective than trimethaphan.
Acase of acute spontaneous subdural hematoma with angiographic extravasation of contrast medium is reported . A56 − year − old man was admitted because he experienced a sudden severe headache , vomiting and a distur − bance of consciousness while washing his car . He had no experience of head injury . On admission , computed tomo − graphy ( CT )revealed an acute subdural hematoma in the right temporoparietal region . Cerebral angiography showed an extravasation of contrast medium from a branch of the angular artery at the edge of the hematoma . After these examinations , the hematoma volume showed no further enlargement and his neurological symptoms improved. Therefore , he was observed under conservative therapy Twenty days after onset , hematoma evacuation with right craniotomy was perfbrmed because he complained of a headache and his CT demonstrated chronic sub − dural hematoma . During operation , bleeding from the cortical branch of the angular artery was found and it was coagulated . He was discharged after 37 days without any neurological de丘ciし The characteristic features of acute spontaneous subdural hernatoma were retrospectively investigated in the literatures . Acute subdural hematoma with an unknown history of head injury should be treated in consideration of possible spontaneous subdural hematoma , (
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.