Response of chronic experimental cerebral vasospasm to methylprednisolone and dexamethasone

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✓ The authors have previously demonstrated that high-dose methylprednisolone (30 mg/kg intravenously every 8 hours) prevents severe chronic vasospasm in dogs. In the present study, lesser doses of methylprednisolone (15 mg/kg intravenously every 8 hours) and dexamethasone (0.1 mg/kg intravenously every 8 hours), although better than no treatment at all, were significantly less effective than the higher dose of methylprednisolone. These data suggest that methylprednisolone can prevent chronic experimental vasospasm from occurring only when given in high doses (30 mg/kg).

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Address reprint requests to: Thoralf M. Sundt, Jr., M.D., Cerebrovascular Research, Joseph Building, Room 5-224, St. Mary's Hospital, Rochester, Minnesota 55901.

© AANS, except where prohibited by US copyright law.

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    Subtraction angiograms of the basilar artery in a dog treated with methylprednisolone (15 mg/kg). A: Baseline appearance of the artery. B: Moderate diffuse arterial spasm is seen on Day 8.

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    Subtraction angiograms of the basilar artery in a dog treated with dexamethasone (0.1 mg/kg). A: Baseline appearance of the artery. B: Moderate diffuse arterial spasm is seen on Day 8.

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    Degree of vasospasm after treatment with 30 mg/kg methylprednisolone (data from Chyatte, et al.2), 15 mg/kg methylprednisolone, or 0.1 mg/kg dexamethasone, or without treatment (data from Chyatte, et al.2). Final basilar artery cross-sectional area is expressed as a percentage of baseline cross-sectional area. The variance shown represents the standard error of the mean. Treatment with 30 mg/kg methylprednisolone resulted in significantly less vasospasm than with either 15 mg/kg methylprednisolone or 0.1 mg/kg dexamethasone (p < 0.005 and p < 0.01, respectively). There was no significant difference between the response to 15 mg/kg methylprednisolone and 0.1 mg/kg dexamethasone. All forms of treatment were significantly more effective than no treatment at all (p < 0.005).

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