Background:Cerebral vasospasm is a proved reaction and nimodipin revolutionised the treatment of subarrachnoid hemorrhage in adult. However, the effectiveness of Nimodipin in cerebral vasospasm remained controversial in intracranial hemorrhage (lCH) in children. Objectives:This study aims to estimate the effectiveness of nimodipin in treatment of children with intracranial hemorrhage.Subjects and method:A descriptive, prospective study was conducted on all children patients diagnosed intracranial hemorrhage and treated at Neurology department of National Hospital for Pediatric, Vietnam from 2004 to June 2007. They applied the Transcranial Doppler sonography (TCD) in diagnosis of vasospasm in intracranial hemorrhage in children and follow-up the evolution after treatment with nimodipin. Results:The results showed that cerebral vasospasm with hight resistance index (RI) on TCD (RI = 0.78 \xb1 0.08) and cerebral ischemie with low systolic velocity (Vs = 68 \xb1 12.2 crn/s) and hight pulsality index (PI = 1.4 \xb1 0.13) were observed in 100% of cases after 3 days with ICH. Nimodipine improved clinical status (71.2%) and CT scan (52%), also RI, PI, Vs returned to normal when used nimodipin within 7 days of ICH. Conclusion: The treatment method for intracranial hemorrhage with nimodipin supplement had proved to have initial effecacy in comparison with traditional method.
Intracranial Hemorrhages/ therapy ; Nimodipine/ therapeutic use ; Infant

Animals ; Calcium Channel Blockers ; therapeutic use ; Dogs ; Hypothermia ; complications ; Male ; Nimodipine ; therapeutic use ; Ventricular Fibrillation ; etiology ; prevention & control

OBJECTIVETo evaluate the effects of urinary kallidinogenase on subarachnoid hemorrhage (SAH) in rabbits.

METHODSRabbits symptomatic cerebral vasospasm model was built though Endo method, among the 40 rabbits, 8 died or had severe nervous system syndrome, the other 32 were randomly divided into 4 groups:group A, control group, injection of normal saline to the cisterna magna;group B, subarachnoid hemorrhage;group C, injection of human urinary tissue kallikreins;group D, treated with Nimodipine. The behavior scores, neurological scores and cerebral angiography changes were observed.

RESULTSFood intake obviously decreased and neurological deficit were seen in group B, while which were attenuated in group C and group D, and group A was normal. Comparing the diameter of basilar artery was (1.9 +/- 0.3) mm before SAH, the diameter of group B 4 d later was (1.5 +/- 0.3) mm, 7 d later (1.4 +/- 0.3) mm, the difference was significant (P < 0.05). Comparing with group C on the day 4th and 7th, the diameters of basilar artery were significantly different (P < 0.001). Comparing with group D on the day 4th, 7th and 14th, there was no obvious improvement.

CONCLUSIONUrinary kallidinogenase and Nimodipine can obviously alleviate symptomatic cerebral vasospasm in rabbits remarkably, but the former's effect of attenuating vasospasm is better than that of Nimodipine.

Animals ; Disease Models, Animal ; Female ; Humans ; Male ; Nimodipine ; therapeutic use ; Rabbits ; Random Allocation ; Tissue Kallikreins ; therapeutic use ; Vasodilator Agents ; therapeutic use ; Vasospasm, Intracranial ; drug therapy

Forty-three patients with aneurysmal subarachnoid hemorrhage entered a nimodipine trial in the Department of Neurosurgery, Yonsei university to determine the efficacy of the drug in preventing vasospasm and to evaluate the tolerability of this calcium channel blocker. Thirty-three patients completed the study. Treatment was started within four days of initial bleeding and continued for two weeks. Delayed neurological deficits developed in seven of the 33 patients-four from vasospasm, two from elevated intracranial pressure, and one from recurrent bleeding. The incidence of symptomatic vasospasm which developed after calcium channel blocker (nimodipine) treatment was 12.1%, which is about one third of the rate experienced at our department during the past five years (33.2%). Twenty-five patients were operated on without surgical mortality and the morbidity rate was 8%. Side effects due to nimodipine treatment were reversible and insignificant. This study suggests that treatment with a calcium channel blocker that has a selective cerebrovascular effect may prevent or reduce the incidence of delayed ischemic deficits in patients with aneurysmal subarachnoid hemorrhage.
Clinical Trials ; Human ; Ischemic Attack, Transient/prevention & control* ; Nimodipine/therapeutic use* ; Prospective Studies ; Subarachnoid Hemorrhage/drug therapy*

OBJECTIVETo provide reliable evidence for acupuncture treatment of vascular dementia (VD).

METHODSMulti-central randomized controlled trial method was adopted and 270 cases enrolled were randomly assigned to an acupuncture-medicine group, an electroacupuncture group and a medication group. The acupuncture-medicine group were treated by scalp electroacupuncture on Sishencong (EX-HN 1), Baihui (GV 20), Shenting (GV 24), Fengchi (GB 20) and oral administration of Nimodipine; the electroacupuncture group were treated with scalp electroacupuncture; the medication group were treated with simple oral administration of Nimodipine. They were treated for 6 weeks. Mini-mental state scale (MMSE), ability of daily life-rating scale (ADL-R) and P300 were detected before and after treatment.

RESULTSThe total effective rate for cognition improvement was 86.59% in the acupuncture-medicine group, 82.05% in the electroacupuncture group and 43.21% in the medication group, the electroacupuncture group and the acupuncture-medicine group being better than the medication group; and their total effective rates for improvement of ability of daily life were 59.76%, 65.38% and 32.10%, respectively, the electroacupuncture group and the acupuncture-medicine group being better than the medication group. Scores for MMSE and ADL-R and P300 examination indicated that there were significant differences as the acupuncture-medicine group and the electroacupuncture group compared with the medication group (P < 0.01).

CONCLUSIONScalp electroacupuncture or scalp electroacupuncture combined with oral administration of Nimodipine has a better therapeutic effect in improvement of recognition function and the ability of life activity than simple oral administration of Nimodipine with a higher safety.

Acupuncture Points ; Aged ; Dementia, Vascular ; drug therapy ; physiopathology ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Nimodipine ; therapeutic use

OBJECTIVETo observe therapeutic effect of Jingjin therapy on migraine and search for an ideal way for non-medical treatment of migraine.

METHODSOne hundred cases of migraine were randomly divided into a observation group and a control group, 50 cases in each group. The observation group were treated with Jingjin therapy, and the control group with oral administration of Nimodipine.

RESULTSThe total effective rate was 100.0% in the observation group and 70.0% in the control group with a significant difference between the two groups (P < 0.01). The therapeutic effect for attacking times, attacking lasting time, headache index and accompanied symptoms in the observation group was better than that in the control group (P < 0.01). CONCLUSION Jingjin therapy has an obvious therapeutic effect on migraine.

Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Migraine Disorders ; therapy ; Nimodipine ; therapeutic use

OBJECTIVETo study the dose- and time-dependent protective effects and the synergistic effects of nimodipine (NMDP) and fructose-1,6-diphosphate (FDP) against cerebral damage induced by acute carbon monoxide (CO) poisoning in mice.

METHODSMale mice were exposed to CO 170 mL/kg, i.p. After CO intraperitonealy exposure, mortality of mice, change in memory function estimated by passive avoidance test, the pathomorphologic observation of brain tissue slices, as well as changes of activities of monoamine oxidase (MAO)-B and Ca(2+)-Mg(2+)-ATPase in cerebral tissue were studied. In dose-dependent protective effect study, NMDP (10.6, 5.3, 2.7 mg/kg) and FDP (2.6, 1.3, 0.67 g/kg) was injected ip, respectively 15 min after CO exposure. To study the time-effect relationship of drugs, NMDP (5.3 mg/kg) and FDP (1.3 g/kg) were administered ip respectively 15 minutes, 45 minutes and 120 minutes after CO exposure. The combination of NMDP (2.7 mg/kg) and FDP (0.67 g/kg) was administered ip15 minutes, 45 min and 120 minutes after CO exposure to study the synergism of the two drugs.

RESULTSEither NMDP (10.6, 5.3 mg/kg) or FDP (2.6, 1.3 g/kg) administered ip within 15 minutes after CO exposure significantly decreased the impairment of memory function and mortality rate induced by CO, inhibited the decrease of Ca(2+)-Mg(2+)-ATPase activity, blunted the rising of MAO-B activity and prevented the delayed hippocampal neuronal death in poisoning mice. To our surprise, the combined use of NMDP (2.7 mg/kg) and FDP (0.67 g/kg) within 15 minutes after CO exposure had similar effects to that in NMDP (10.6, 5.3 mg/kg) and FDP (2.6, 1.3 g/kg).

CONCLUSIONSThese results suggest that the impairment of CO on brain can be attenuated if NMDP or FDP are administered sufficiently and quickly as soon as possible after CO exposure and there exists a synergism of FDP and NMDP against CO poisoning damage.

Animals ; Brain Damage, Chronic ; prevention & control ; Calcium Channel Blockers ; therapeutic use ; Carbon Monoxide Poisoning ; prevention & control ; Dose-Response Relationship, Drug ; Drug Synergism ; Fructosediphosphates ; therapeutic use ; Male ; Mice ; Neuroprotective Agents ; therapeutic use ; Nimodipine ; therapeutic use ; Time Factors

OBJECTIVE: The management of patients with ruptured cerebral aneurysms and severe vasospasm is subject to considerable controversy. We intended to describe herein an endovascular technique for the simultaneous treatment of aneurysms and vasospasm. MATERIALS AND METHODS: A series of 11 patients undergoing simultaneous endovascular treatment of ruptured aneurysms and vasospasm were reviewed. After placement of a guiding catheter within the proximal internal carotid artery for coil embolization, an infusion line of nimodipine was wired to one hub, and of a microcatheter was advanced through another hub (to select and deliver detachable coils). Nimodipine was then infused continuously during the coil embolization. RESULTS: This technique was applied to 11 ruptured aneurysms accompanied by vasospasm (anterior communicating artery, 6 patients; internal carotid artery, 2 patients; posterior communicating and middle cerebral arteries, 1 patient each). Aneurysmal occlusion by coils and nimodipine-induced angioplasty were simultaneously achieved, resulting in excellent outcomes for all patients, and there were no procedure-related complications. Eight patients required repeated nimodipine infusions. CONCLUSION: Our small series of patients suggests that the simultaneous endovascular management of ruptured cerebral aneurysms and vasospasm is a viable approach in patients presenting with subarachnoid hemorrhage and severe vasospasm.
Adult ; Aged ; Aneurysm, Ruptured/*therapy ; Carotid Artery, Internal/radiography ; Embolization, Therapeutic ; *Endovascular Procedures ; Female ; Humans ; Intracranial Aneurysm/*therapy ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Nimodipine/therapeutic use ; Retrospective Studies ; Vasodilator Agents/therapeutic use ; Vasospasm, Intracranial/*therapy

OBJECTIVETo evaluate the effect of intraoperative continuous nimodipine infusion on cerebral vasospasm during intracranial aneurysm surgery.

METHODSThirty consecutive patients under-going intracranial aneurysmal surgery were prospectively randomized into two groups: Isoflurane (group A, n = 15) and nimodipine (group B, n = 15). The patients in group A were maintained with 1 minimum alveolar concentration (MAC) isoflurane anesthesia during the whole procedure. The patients in group B were given nimodipine infusion continuously (20 microg.kg(-1).h(-1)) after induction of anesthesia and anesthetized with 1 MAC isoflurane. S100B levels in cerebrospinal fluid were determined before aneurysm clipping and 0, 2, 4 h after aneurysm clipping by enzyme linked immunosorbent assay. Assessment of mean blood flow velocity of parent arterial and arterial branches were performed before and after aneurysm clipping.

RESULTS(1) S100B in cerebrospinal fluid was increased significantly at 4 h after aneurysm was clipped in group A (F = 4.11, P < 0.05). However, S100B in cerebrospinal fluid was stable in group B in the whole procedure. (2) Mean arterial flow velocity of parent vessels in group B was lower significantly than that in group A (t = 2.08, P < 0.05). However, mean arterial flow velocity of distal vessels in both groups has no significant difference.

CONCLUSIONIntraoperative nimodipine infusion may prevent cerebral vasospasm during intracranial aneurysm surgery.

Adult ; Aged ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Anesthetics, Intravenous ; administration & dosage ; Female ; Humans ; Intracranial Aneurysm ; surgery ; Intraoperative Complications ; prevention & control ; Isoflurane ; administration & dosage ; Male ; Middle Aged ; Nimodipine ; therapeutic use ; Vasodilator Agents ; therapeutic use ; Vasospasm, Intracranial ; prevention & control

OBJECTIVETo assess the therapeutic effect of auricular point taping and pressing therapy on vascular dementia (VD).

METHODSOne hundred and eighty cases of vascular dementia were randomly divided into an auricular point taping and pressing group and a western medicine group, 90 cases in each group. The auricular point taping and pressing group was treated by auricular point taping and pressing at auricular points Shennen, Nao (brain), Shen (kidney), Zhen (pulvinal), and the western medicine group by oral administration of Nimodipine, thrice each day, 30 mg each time. They were treated for 12 weeks. The scores of mini-mental state examination (MMSE) and activities of daily living (ADL), and adverse reaction were observed.

RESULTSThe scores of MMSE before treatment and 12 weeks after treatment were 18.00 +/- 3.88 and 20.83 +/- 3.74 in the auricular point taping and pressing group, and 17.80 +/- 3.82 and 20.70 +/- 3.53 in the western medicine group, respectively, with significant increases in scores of MMSE after treatment in the two groups (both P < 0.01) and with no significant difference between the two groups (P > 0.05). The scores of ADL before treatment and 12 weeks after treatment were 44.90 +/- 14.84 and 39.60 +/- 12.45 in the auricular point taping and pressing group, and 45.70 +/- 14.86 and 39.10 +/- 13.44 in the western medicine group, respectively, with significant decreases after treatment in the two groups (both P < 0.01) and with no significant difference between the two groups (P > 0.05). In the auricular point taping and pressing group, 2 cases withdrew from the test because adhesive plaster allergic reaction induced severe itch of the auricle. In the western medicine group, one case had mild dizziness and another case had diarrhea respectively.

CONCLUSIONAuricular point taping and pressing and Nimodipine have similar therapeutic effect on vascular dementia, and have no obvious adverse reaction, except adhesive plaster allergic reaction.

Acupuncture Points ; Aged ; Aged, 80 and over ; Dementia, Vascular ; drug therapy ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Ear, External ; drug effects ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Nimodipine ; therapeutic use