Intra-arterial infusion of fasudil hydrochloride to treat post-traumatic cerebral vasospasm

Acute Med Surg. 2019 Apr 19;6(4):392-395. doi: 10.1002/ams2.420. eCollection 2019 Oct.

Abstract

Background: The effect of intra-arterial infusion of fasudil hydrochloride in patients with post-traumatic cerebral vasospasm remains unclear. Here we report a case of intra-arterial infusion of fasudil hydrochloride for post-traumatic cerebral vasospasm.

Case presentation: A 47-year-old man was transferred to our hospital with a fractured skull and traumatic subarachnoid hemorrhage. As rhinorrhea of cerebrospinal fluid had not improved, repair surgery was carried out on day 4. Aphasia appeared on day 13. Magnetic resonance imaging and angiography showed an ischemic region in the left temporal lobe and vasospasm of the left middle cerebral artery. We immediately carried out angiography and diagnosed severe vasospasm of the M1 region of the left middle cerebral artery. After placing a microcatheter into the proximal middle cerebral artery, we injected fasudil hydrochloride intra-arterially. Vasospasm improved and aphasia resolved.

Conclusion: In this case, intra-arterial infusion of fasudil hydrochloride was effective against post-traumatic cerebral vasospasm.

Keywords: Endovascular; fasudil hydrochloride; intra‐arterial infusion; ischemic region; post‐traumatic cerebral vasospasm.

Publication types

  • Case Reports