Trial reportNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2014
Effectiveness of papaverine cisternal irrigation for cerebral vasospasm after aneurysmal subarachnoid hemorrhage and measurement of biomarkers.
Trial report in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 5 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 5 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Pressure-controlled active CSF irrigation versus non-pressure-controlled management following aneurysmal subarachnoid hemorrhage: a systematic review and comparative meta-analysis of DCI and safety outcomes.Neurosurgical review · 2026Pooled it
- Cisternal and intraventricular irrigation in subarachnoid and intraventricular haemorrhage.Stroke and vascular neurology · 2025Pooled it
- Efficacy of endovascular therapy for cerebral vasospasm following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.Frontiers in neurology · 2024Pooled it
- Treatment of cerebral vasospasm following aneurysmal subarachnoid haemorrhage: a systematic review and meta-analysis.European radiology · 2017Pooled it
- Delayed cerebral ischaemia prevention and treatment after aneurysmal subarachnoid haemorrhage: a systematic review.British journal of anaesthesia · 2016Pooled it
- Comparative efficacy of cisternal drainage versus external ventricular drainage in severe aneurysmal subarachnoid hemorrhage.PloS one · 2026Article
- Computational Insights into Papaveroline as an In Silico Drug Candidate for Alzheimer's Disease via Fyn Tyrosine Kinase Inhibition.Molecular biotechnology · 2025Article
- Cannabidiol's Multifactorial Mechanisms Has Therapeutic Potential for Aneurysmal Subarachnoid Hemorrhage: a Review.Translational stroke research · 2023Review
- Circular RNA hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm: Closely relating to the volume of hemorrhage.Brain and behavior · 2023Article
- Papaverine: A Miraculous Alkaloid from Opium and Its Multimedicinal Application.Molecules (Basel, Switzerland) · 2023Review
- Papaverine, a Phosphodiesterase 10A Inhibitor, Ameliorates Quinolinic Acid-Induced Synaptotoxicity in Human Cortical Neurons.Neurotoxicity research · 2021Article
- The phosphodiesterase 10 inhibitor papaverine exerts anti-inflammatory and neuroprotective effects via the PKA signaling pathway in neuroinflammation and Parkinson's disease mouse models.Journal of neuroinflammation · 2019Article
- Cascade Signals of Papaverine Inhibiting LPS-Induced Retinal Microglial Activation.Journal of molecular neuroscience : MN · 2019Article
- Papaverine inhibits lipopolysaccharide-induced microglial activation by suppressing NF-κB signaling pathway.Drug design, development and therapy · 2016Article
- Delayed morbidity and mortality in aneurysmal subarachnoid hemorrhage patients: effect of attenuating cerebral vasospasm.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2015Article
- Inflammation, vasospasm, and brain injury after subarachnoid hemorrhage.BioMed research international · 2014Review
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cisternal irrigation with thrombolytic agents was used to prevent post-SAH vasospasm, but its role remained inconclusive. To verify effectiveness of papaverine (PPV) in preventing vasospasm, we studied relationship between inflammatory biologic markers and vasospasm. This prospective study included 121 patients with clipped anterior circulation aneurysms that had ruptured, and 372 control patients. Patients were divided into three groups according to cisternal irrigation method: simple drain, papaverine group, and urokinase (UK) group. Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were determined in CSF and serum on days 3 and 7 after SAH. The PPV group showed similar incidence of vasospasm with UK group, but lower incidence than the simple drain group. The levels of ICAM-1 and VCAM-1 were significantly higher in the SAH group than in the control group. CSF and serum levels were more elevated on day 7 than day 3, and the degree of elevation were more marked when measured in the CSF than in the serum. However, there was no statistical difference between measured levels of ICAM-1 and VCAM-1, and vasospasm development. PPV cisternal irrigation was similarly effective as UK at preventing vasospasm. Although neither PPV nor UK irrigation could reduce the concentration of adhesion molecules compared with simple drain, we found levels of ICAM-1 and VCAM-1 were specifically elevated in the CSF. Therefore, further research should focus on anti-inflammation as a therapeutic target against cerebral vasospasm and on the CSF as the optimum place where such inflammatory action practically brought about.
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