Barbiturate-induced coma therapy for focal cerebral ischemia

Effect after temporary and permanent MCA occlusion

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  • 1 University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio
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✓ The authors have studied the therapeutic effect of barbiturate coma following middle cerebral artery (MCA) occlusion in primates. The relationship of the efficacy of barbiturate protection to the presence or absence of recirculation was examined. Barbiturate therapy was begun 30 minutes after MCA occlusion. The findings were as follows: 1) barbiturate-induced coma, with its attendant monitoring, was safely tolerated by primates for 96 hours; 2) 6 hours of MCA occlusion followed by recirculation resulted in a neurological deficit that was worse than the neurological deficit produced by permanent MCA occlusion; 3) barbiturate-induced coma for 96 hours, initiated 30 minutes after the onset of MCA occlusion, in the absence of reperfusion, was in fact detrimental; 4) barbiturate-induced coma for 96 hours, initiated 30 minutes after MCA occlusion, with the establishment of reperfusion at 6 hours, provided nearly complete protection from ischemic damage.

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Contributor Notes

Dr. Selman is the recipient of the Allen Memorial Research Fellowship for 1978–1980.

Address reprint requests to: Robert F. Spetzler, M.D., University Hospitals of Cleveland, 2074 Abington Road, Cleveland, Ohio 44106.
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