What medicine should I take for cerebral vasospasm? Systemic treatment is recommended

For cerebral vasospasm, we can alleviate the symptoms of the disease through drug treatment, and the effect is very good. However, the severity of the disease has a lot to do with the choice of medicine. If necessary, we must use medicine according to the condition.

1. Early use of cerebral vasodilators and volume expanders can significantly reduce and terminate the clinical onset of TIA. You can choose to add 20 mg of betahistine injection to 500 ml of 5% glucose injection, or 500 ml of low molecular weight dextran or 706 generation plasma for intravenous drip. Vincaine, Sibelium, etc. may also have certain effects.

2. Antiplatelet aggregation agents can reduce the occurrence of microemboli. Patients without ulcer or bleeding diseases are often treated with aspirin at a daily dose of 50mg to 300mg. Most people believe that a smaller dose is appropriate, and the dose can be reduced if taken for a long time. The combination of dipyridamole (25 mg 3 times a day) and aspirin can produce a synergistic effect and reduce the dose of aspirin. If the patient is not suitable for aspirin or the aspirin effect is not ideal, ticlopidine (Ticlopidine 200-250 mg, 1-2 times a day) or ticlid 250 mg, once a day) can be used instead. During treatment, attention should be paid to strengthening the prevention and treatment of toxic side effects such as bleeding.

3. For patients with frequent attacks, severe and progressively worsening illness, and without obvious contraindications to anticoagulant treatment, early anticoagulant treatment has a positive significance in reducing attacks and preventing cerebral infarction. Heparin 12500U is usually added to 5% glucose saline and slowly dripped intravenously. At the same time, 300mg of cyproconazole, 100-200mg of cyproconazole, or 4-6mg of warfarin can be taken orally on the first day. Check the prothrombin time and activity every day, and measure them once a week after they stabilize to adjust the oral dosage. The venous clotting time should be maintained at 20-30 minutes and the prothrombin activity should be maintained at 15-25%. The subsequent maintenance dose is 150-225 mg of cypermethrin, 25-75 mg of cypermethrin or 2-4 mg of warfarin. During treatment, attention should be paid to preventing and treating bleeding complications. When stopping the drug, the dosage should be reduced gradually to avoid a "rebound effect". Because this treatment is difficult to control the dosage and has many bleeding complications, it is rarely used in China.