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Effect on Ischemia of Nicardipine Hydrochloride in Acute Intracerebral Hemorrhage: Perfusion Computed Tomography Study
Do Kyeun Jeong, Sung kyun Hwang
Department of Neurosurgery, College of Medicine, Ewha Womans University, Seoul, Korea
Correspondence  Sung kyun Hwang ,Tel: 0226502872, Fax: 0226502652, Email: nshsg@ewha.ac.kr
Received: September 4, 2018;  Accepted: September 12, 2018.  Published online: September 12, 2018.
Object: We performed brain perfusion CT studies to correlate the effect of intravenous niacinamide hydrochloride with ischemia around the hematoma in patients with intracerebral hemorrhage (ICH).
Thirty-two patients 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 computed tomography (CT) to determine if there is any ischemia around the hematoma and the contralateral normal site at the time of admission and after 24 hours twice. Result: 32 patients in this study, Systolic blood pressure and diastolic blood pressure were significantly decreased after Nicardipine administration, and perihematoma CBF was not significant different from that of the normal contral lateral site after 24 hours 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. But there were no significant changes between the two groups.
This study suggests that lowering blood pressure 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.
Key words: intracerebral hemorrhage; perfusion computed tomography; nicardipine hydrochloride; cerebral blood flow
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Related article
Effect on Ischemia of Nicardipine Hydrochloride in Acute Intracerebral Hemorrhage: Perfusion Computed Tomography Study  2018 October;4(2)
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