Summary
The study evaluated the effectiveness of the combination of nimodipine and cyclosporine A vs nimodipine alone in the prevention of delayed neurologic deficit in 82 (31 plus 51) patients in whom intracranial aneurysms were clipped within 72 h after subarachnoid haemorrhage.
The tests performed included examination of the neurological condition before and after operation, angiography of cerebral arteries to visualize vasospasm, and analysis of the distribution and amount of blood in the brain fluids and/or tissue according to Fisher's scale. Inclusion of cyclosporine A in the treatment was clearly beneficial for the neurological condition.
While cyclosporine A did not appear to produce a statistically significant improvement as evaluated by the chi-square test, a positive result was obtained following analysis of the correlation coefficients after Pearson in combination with the logistic log-linear regression analysis. The results argue against the utility of the chi-square test for verifying clinical data obtained in a limited number of patients.
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References
Bishop YMM, Fienberg SE, Holland PW (1975) Discrete multivariate analysis. Theory and Practice. MIT Press, Cambridge, Mass
Commengers D, Dartigues JF, Peytour PH, Puymirat E, Henry P, Gagnon M (1989) A strategy for analysing multiple risk factor with application to cervical pain syndrome. Methods of information in medicine. 28: 14–19
Daverat P, Castel JP, Dartigues JF, Orgogozo JM (1991) Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis. Stroke 22: 1–6
Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid visualized by computerized tomographic scanning. Neurosurgery 6: 1–9
Haberman SJ (1978) Analysis of quantitative data, Vol 1. Academic Press, London
Handra Y, Hayashi M, Takeuchi H, Kobayashi J, Kawano H (1990) Effect of immunosuppressive drug on the development of cerebral vasospasm after subarachnoid hemorrhage in primates. In: Sano K, Takamura K, Kassell NF, Sasaki T (eds) Proceedings of the IVth International Conference on Cerebral Vasospasm. University of Tokyo Press, Tokyo, pp 379–381
Handra Y, Hayashi M, Takeuchi H, Kabayashi H, Kawano H, Kabuto M (1991) Effect of cyclosporine on the development of cerebral vasospasm in a primate model. Neurosurgery 28: 380–386
Hijdra A, van Gijn J, Nagelkerke NJD, Vermeulen M, van Crevel H (1988) Prediction of delayed cerebral ischemia, rebleeding and outcome after aneurysmal subarachnoid hemorrhage. Stroke 19: 1250–1256
Jannett B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet 1: 480–484
Hunt WE, Kassell N, Pertuiset B, Sano K, Teasdale G, Villiers De JC, Drake CG (1988) Report of World Federation of Neurological Surgeons. Committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg 68: 985–986
Pellettieri L, Carlsson CA, Lindholm L (1981) Is the vasospasm following subarachnoid hemorrhage an immunoreactive disease? Experientia 37: 1170–1171
Peterson JW, Kwun B, Nishizawa S, Hackett JD, Zervas NT (1988) Immunoreactivity, immunosuppression, and cerebral vasospasm following SAH. Stroke 19: 132
Peterson JW, Nishizawa S, Hackett JD, Bun T, Teramura A, Zervas NT (1990) Cyclosporine A reduces cerebral vasospasm after subarachnoid hemorrhage in dogs. Stroke 21: 133–137
Peterson J, Nishizawa S, Teramura A, Candia G, Bun T, Spanes A, Zervas N (1990) Calmodulin — antagonism and immunosuppression in cerebral vasospasm. In: Sano K, Takakura K, Kassell NF, Sasaki T (eds) Proceedings of the IVth International Conference of Cerebral Vasospasm. University of Tokyo Press, Tokyo, pp 375–378
Ryba M, Pastuszko M, Bidziński J, Iwańska K, Dziewięcki C (1990) Immunosuppressive treatment reduces the neurological deficit after early clipping of ruptured aneurysm. In: Sano K, Takakura K, Kassell NF, Sasaki T (eds) Proceedings of the IVth International Conference of Cerebral Vasospasm. University of Tokyo Press, Tokyo, pp 382–384
Ryba M, Pastuszko M, Bidziński J, Iwańska K, Dziewięcki C (1991) Cyclosporine A prevents neurological deterioration of patients with SAH — a preliminary report. Acta Neurochir (Wien) 112: 25–27
Ryba M, Grieb P, Bidziński J, Pastuszko M, Dziewięcki C, Iwańska K (1991) Cyclosporine A for prevention of neurological deficit following subarachnoid hemorrhage in humans. Stroke 22: 531
Ryba M, Iwańska K, Walski M, Pastuszko M (1991) Immunomodulators interfere with angiopathy but not vasospasm after subarachnoid haemorrhage in rabbits. Acta Neurochir (Wien) 108: 81–84
Sano K, Saito I (1978) Timing and indication of surgery for rupture of intracranial aneurysms with regard to cerebral vasospasm. Acta Neurochir (Wien) 41: 49–60
Sengupta RP, McAllister VL (1986) Vasospasm and neurological condition of the patient. In: Subarachnoid haemorrhage. Springer, Berlin Heidelberg New York Tokyo, pp 274–275
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Ryba, M., Pastuszko, M., Dziewięcki, C. et al. A strategy for analyzing multiple parameters with application to aneurysmal SAH patients all of them clipped but treated with and without cyclosporine. Acta neurochir 122, 194–199 (1993). https://doi.org/10.1007/BF01405528
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DOI: https://doi.org/10.1007/BF01405528