Intra-arterial Nimodipine for the Treatment of Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage : Preliminary Report Clinical Research.
- Author:
Jae Won LEE
1
;
Keon Ha KIM
;
Sung Ki AHN
Author Information
1. Department of Neurosurgery, College of Medicine, Hallym University, Anyang, Korea. askns@hallym.ac.kr
- Publication Type:Original Article
- Keywords:
Subarachnoid hemorrhage;
Symptomatic cerebral vasospasm;
Intra-arterial nimodipine
- MeSH:
Aneurysm*;
Angiography;
Basilar Artery;
Carotid Artery, Internal;
Cerebral Angiography;
Dilatation;
Follow-Up Studies;
Humans;
Nimodipine*;
Subarachnoid Hemorrhage*;
Vasodilation;
Vasospasm, Intracranial*
- From:Korean Journal of Cerebrovascular Surgery
2005;7(3):218-223
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: We evaluated the efficacy of intra-arterial nimodipine, a calcium-channel blocker acting mainly on cerebral vessels, in patients with symptomatic cerebral vasospasm following subarachnoid hemorrhage. METHODS: Clinical records of 8 consecutively treated patients were reviewed. Patients were considered to determine the indication for cerebral angiography and subsequent endovascular treatment if they presented symptomatic cerebral vasospasm. Nimodipine was infused intra-arterially via microcatheter in the internal carotid artery or basilar artery at a rate of 0.1 mg/min. Immediate angiographic vasodilatation and clinical improvement were assessed. RESULTS: Thirteen procedures were performed in 8 patients. Clinical improvement was observed in 7 (88%) patients. 5 of 8 patients were clinically improved within 24 hours after the first endovascular treatment, and two after the third. The notable arterial dilatation at postprocedural angiography was observed in 9 (70%) of 13 procedures. After follow-up of 3-6 months, 7 (88%) patients had a favorable outcome (Glasgow Outcome Scale score of 5-4). No procedure related complications were observed. CONCLUSION: Intra-arterial nimodipine infusion is effective and safe for the treatment of symptomatic vasospasm after subarachnoid hemorrhage. Further prospective randomized studies are needed to support these results.
