Haemorheology and cerebrovascular disease: multifunctional approach with pentoxifylline

New aspects in the pathophysiology of chronic cerebral ischaemia as the cause of the multiform syndromes of cerebrovascular disorders are reviewed and therapeutic approaches are discussed. It is suggested that the fatal vicious circles of the disturbances of nutritive blood flow within the decompensated cerebral microcirculation can by interrupted by pentoxifylline. By amelioration of the disturbed flow properties of blood in the affected capillary regions through inhibition of red cell and platelet aggregation, improvement of red cell deformability and reduction in blood viscosity, oxygen supply is enhanced and more glucose is made available. Membrane permeability and function of the cell are normalized by the favourable inhibitory action of pentoxifylline on oedematous changes in the brain tissue and mechanical obstacles in the micro-circulation are removed. The disturbed cerebral metabolism is directly stimulated by compensation of the impaired energetic balance. The combined rheological, antioedematous and metabolic effects of pentoxifylline offer a multifunctional therapy of cerebrovascular circulatory disorders.