No abstract available.
Administration, Intravenous* ; Nimodipine* ; Rabbits* ; Subarachnoid Hemorrhage*

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

The nimodipine, calcium-channel blocker, is known to specific to brain tissue and effect on the ischemic stroke. To evaluate the efficacy and tolerability of nimodipine, we studied the 37 patients with Organic Brain Syndrome(OBS) who admitted to St. Mary's Hospital from January to August, 1989. We followed up for 12 weeks of their 18 items of neurologic outcome. The results and conclusion were as follows: 1) The pretreatment SCAG(Sandoz Clinical Assessment-Geriatric Scale) was used as a base-line measurement and the efficacy of the therapy was evaluated entirely in terms of changes in SCAG after 3, 6, 9 and 12 weeks of treatment. The total score was changed with meaningful improvement(p<0.01). 2) Among the 18 items of symptoms, the confusion, the level of alertness, the memory and the orientation were the area that have showed the most improvement. 3) No effect on heart, blood chemistry or other side effect was noted during medication. 4) We also found that those improvement has no specific relation to age, sex and causes of OBS. These result indicate that nimodipine has a possible therapeutic benefit in patients with OBS, especially who have the symptoms of confusion and impaired recent memory. These result should encouraged us to do further study such as double blind placebo in order to clarify the genuine pharmacological efficacy.
Brain* ; Chemistry ; Heart ; Humans ; Memory ; Nimodipine* ; Stroke

To evaluate the effectiveness and to find out which grade(clinical and computed tomography) of subarachnoid hemorrhage(SAH) patients are most effected with the medication of the calcium antagonist, we did this study. We selected 339 cases(study cases) among a total of 603 cases of SAH who were admitted to our hospital from Sept. 1982 to Aprial 1991. The criteria of study cases are patients who were admitted and who had a brain computed tomography(CT) taken within 3 days after the SAH and who had a clinical grade(Hung & Hess) on admission between I-IV. We divided study cases into 3 groups. Group I:surgery was done more than 7 days after the SAH and together with non-surgical patients, no medication was used(N=126). Group II:surgery was done more than 7 days after teh SAH and together with non-surgical patients medication of the calcium antagonist was given orally(N=120). Group III:surgery was done more than 7 days after the SAH and together with non-surgical patients, medication of nimodipine intravenously was given, and also patients, medication of nimodipine intravenously was given, and also patients who received surgery did within 3 days after the SAH were given intravenous injection and cisternal irrigation of nimodipine(N=93). We compared the overall management outcome and the incidence of delayed ischemic dificit(DID) and unfavorable outcome due to DID in each group. We also analyzed the causes of unfavorable outcome according to the clinical grade on admission and the amount of blood in the cistern seen on the brain CT in each group. The results of this study showed that overall management outcome was improved by using the calcium antagonist. The calcium antagonist reduced the incidence of DID as well as the unfavorable outcome related to DID. In clinical grade III patients on admission, the unfavorable outcome due to DID was significantly lower in group II and III than in I(group I vs. II:p<0.05, group I vs. III:P<0.01). In cases with a large amount of blood in the cistern seen on the brain CT, the unfavorable outcome was significantly lower in groups II and III than in I(group I vs. II:p<0.01, group I vs. III:p<0.05). We conclude that the overall management outcome of aneurismal SAH patients may be improved by using a calcium antagonist and the effect of the calcium antagonist is prominent in clinical grade III patients on admission and patients with a large amounts of blood in the cistern seen on the brain CT.
Aneurysm* ; Brain ; Calcium* ; Humans ; Incidence ; Injections, Intravenous ; Nimodipine ; Subarachnoid Hemorrhage*

In order to elucidate the clinical effectiveness of nimodipine treatment, we analyzed 322 consecutive patients with the aneurysmal subarachnoid hemorrhage operated between September, 1987 and December, 1991. The nimodipine treatment group of one hundred and forty-two patients(44.1%) was compared with the control group of one hundred and eighty patients(55.9%) treated without nimodipine during this period. The patients were randomly allocated to either group. The nimodipine was infused intravenously at 30 microgram/Kg/hr for the first week beginning on the day of admission and then given orally at 360 mg/day for the following two weeks. Statistical anayses were done using the Student's t-test and clinical variables were compared using the chi-square, Mantel-Haenszel chi-square, two-tailed Fisher's exact test. There was no difference in clinical and radiological variables known to influence the outcome of the disease, such as age, sex, presence of hypertension, history of previous subarachnoid hemorrhage, preoperative categorization by Hunt and Hess grade and Fisher's classification, presence of hydrocephalus, location of aneurysm, multiplicity and vasospasm on preoperative angiography(p>0.05). The only difference was in the timing of surgery(p<0.05). The functional outcome, mortality and morbidity, and mortality due to delayed ischemic deficits were not significantly different (p>0.05, respectively). The number of patients with good functional recovery and the number of who developed delayed ischemic deficit(DID) were not significantly different between the group (P>0.05), respectively. Nimodipine treatment did not improve the rate of good outcome in the aneurysmal subarachnoid hemorrhage in our study.
Aneurysm* ; Classification ; Humans ; Hydrocephalus ; Hypertension ; Mortality ; Nimodipine* ; Subarachnoid Hemorrhage*

We describe a patient with infective endocarditis (IE) complicated by mycotic cerebral aneurysms (MCAs). Transarterial embolization of a larger MCA was attempted but failed. Aneurysmal clipping through craniotomy was followed by mitral valvuloplasty. During mitral valvuloplasty for IE, the low values of cerebral oxygen saturation after aneurysmal clipping were improved by continuous nimodipine infusion. We also review anesthetic management of patients with IE complicated by MCAs.
Aneurysm ; Craniotomy ; Endocarditis ; Humans ; Intracranial Aneurysm ; Nimodipine ; Oxygen

The effect of the calcium antagonist nimodipine on the feline cerebral cortical blood flow in experimentally induced subarachnoid hemorrhage(SAH) was studied. Cerebral cortical blood flow was measured in the middle cerebral territory at specified intervals by the hydrogen clearance method. SAH was induced in 25 cats by a slow injection of fresh autogenous arterial blood into the cisterna magna. Twenty-five cats were divided into 5 groups of 5 cats each according to the timing of the cerebral cortical blood flow measurements after SAH ; immediate(Group la, lb), 24 hours(Group 2), 48 hours(Group 3) and 7 days (Group 4). Cerebral cortical blood flow dereased by 55.5%, 39.2%, 41.4%, and 38.3% from pre-SAH levels in each group respectively. During nimodipine infusion(1 microgram/kg/min) cerebral cortical flow increased by 89.0%, 51.8%, 87.5% and 24.5% from pre-nimodipine infusion levels in each group respectively. Mean arterial blood pressure(MABP) after cisternal blood injection increased by 6.5% from pre-SAH levles, and MABP during nimodipine infusion decreased by 15.4% from pre-Nimodipine infusion levels. The calcium antagonist nimodipine increased cerebral cortical blood flow significantly in experimentally induced SAH without considerable changes of MABP. Results are considered promising for trials in the treatment and prevention of cerebral by vasospasm following SAH.
Animals ; Calcium* ; Cats ; Cisterna Magna ; Hydrogen ; Nimodipine* ; Subarachnoid Hemorrhage*

To determine the factors affecting development and recovery of symptomatic vasospasm, the author analyzed the results of patients with ruptured intracranial aneurysms treated by nimodipine and prophylactic "triple-H" therapy. From January 1991 to December 1995, 199 patients underwent surgery for ruptured intracerebral aneurysms. Combined hypervolemic hemodilution was initiated at the time of admission. Induced hypertension was added immediately after surgery(aneurysmal neck clipping). All patients received nimodipine intravenously or orally until the 14th day of SAH. Sixty patients underwent surgery on Day 0 through 2 after attackes of subarachnoid hemorrhage(Group A), 105 patients on Day 3 through 14(Group B), and 34 patients after Day 14(Group C). Of 199 patients, 76(38%) patients suffered from symptomatic vasospasm. Symptomatic vasospasm occurred in 34% of Group A patients, 33% of Group B patients, and 5% of Group C patients. Symtomatic vasospasm occurred more frequently in the older age group, the Fisher group 3, and Hunt & Hess grades 3, 4 and 5 groups. Of 76 patients who suffered from symptomatic vasospasm, 47(62%) patients recovered completely. The author analyzed the relationship between recovery rate and sex, age, Hunt & Hess grade and Fisher group among these 76 patients. Recovery rates between these groups were not significantly different. Based on this experience, the author believes that Hunt-Hess grade, Fisher group, and age are important factors affecting symptomatic vasospasm development.
Aneurysm ; Hemodilution ; Humans ; Hypertension ; Intracranial Aneurysm ; Neck ; Nimodipine

In order to investigate the antiepileptic effects of calcium antagonist, nimodipine, we studied the changes of seizure pattern and electroencephalographic finding of the epileptic rats before and after nimodipine administration which were induced by stereotaxic instillation of penicillin solution into the right amygadala. 40 Sprague-Dowley rats were divided into 2 groups:the control group(n=10) which underwent craniectomy on the biparietal area and was instilled penicillin solution into the right amygdala on the basis of stereotaxic coordinates, and the experimental group(n=30) which was subdivided into 3 subgraups:nimodipine pre-treatment group(n=10), nimodipine 0 minute post-treatment group(n=10) and nimodipine 20 minutes post-treatment group(n=10) depending on the intraperitoneal administration time of nimodipine. The results were as follows; 1) In control group typical epileptiform discharges were noted at 3.4+/-1.9 mm after penicillin instillation and the frequency and amplitude of discharges were 9.8+/-2.2/sec, 25.0+/-3.9mm/50+/-microV. The degree of behavioral seizure was between stage IV and VI. 2) In nimodipine pre-treatment group, there was inhibitory effects of seizure development. The frequency and amplitude were significantly decreased and the degree of behavioral seizure was attenuated in comparison to that of control group. 3) There was no statistical difference in effects of penicillin induced seizure between nimodipine 0 minute, 20 minutes post-treatment and control group. This experiment provided that calcium antagonist showed inhibitory effects on the penicillin-induced epileptic rats, but did not prevent seizure propagation. And calcium currents might play a role to evoke seizure. Therefore calcium antagonist "nimodipine" might be beneficial to the treatment of patients with seizure.
Amygdala ; Animals ; Calcium ; Electroencephalography* ; Humans ; Nimodipine* ; Penicillins ; Rats* ; Seizures*

The author has performed an experimental study in order to investigate the effect of nimodipine on the production of CSF in 12 cats. The cats were divided into 2 groups, one for nimodipine intravenous infusion and the other for its vehicle infusion group. Using ventriculo-cisternal perfusion method, nimodipine and its vehicle were examined for their effects on CSF formation rate respectively. Baseline CSF formation rate was 22.5+/-2.9 microliter/min(S.E.) and it gradually reduced to 17.0+/-3.4 microliter/min(S.E.) after final infusion of nimodipine at 60 microgram/kg/min. Vehicle infusion revealed no significant change in CSF formation rate. Although the nimodipine insuion revealed declining tendency in CSF formation rate along with increment of nimodipine concentration, it was not statistically different from that of vehicle infusion group. Systolic blood pressure was significantly reduced after nimodipine infusion(133+/-31.8mmHg at baseline, 93.9+/-19.1mmHg at the end of the experiment) on oneway ANOVA test and it was significantly different from that in vehicle infusion group(p<0.01).
Animals ; Blood Pressure ; Cats ; Infusions, Intravenous ; Nimodipine* ; Perfusion