Specific Calcium Antagonism: A New Therapeutic Principle in Cerebrovascular Diseases?

“Calcium antagonism” now plays an accepted therapeutic role in cardiovascular diseases. Especially in coronary spasm, calcium antagonists have become the therapy of first choice. According to Allen et al. (1979), Hayashi et al. (1977), and Towart (1981), the cerebral vascular smooth muscle is still more sensitive to drugs blocking the calcium influx. Especially the dihydropyridine named nimodipine, a derivative of nifedipine, shows a predilective cerebrovascular action in animal experiments. Here, it was able to inhibit the vascular spasm following experimental subarachnoid hemorrhage as well as the postischemic impaired reperfusion in different models of cerebral ischemia. According to Kazda et al. (1979), Hoffmeister et al. (1979), and Takagi et al. (1979), nimodipine particularly inhibits the spasmogenic calcium influx following potassium depolarization of the vascular smooth muscle. This mechanism may also have great importance in vasospasm after SAH (Brawanski et al. 1982; Gaab et al. 1982).