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

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

OBJECTIVETo observe the effect of a integrative medical regimen (IMR), i.e. combined use of Jiangya Capsule (JYC) and Nimodipine (ND), on blood pressure, TCM clinical symptoms, and blood levels of vascular endothelial function and hypersensitive C-reactive protein (hs-CRP) in elderly patients with isolated systolic hypertension (EISH).

METHODSAdopting randomized, double-blinded and controlled principle, a trial was conducted on 135 patients with EISH by randomized them into three groups, they were administered IMR (Group A), JYC plus ND simulator (Group B) and ND plus JYC simulator (Group C) respectively, for 4 weeks. Changes of blood pressure and TCM symptoms, as well as the levels of serum nitric oxide (NO), plasma endothelin-1 (ET-1), 6-keto-prostaglandin 1alpha (6-keto-PGF(1alpha)), thromboxane B2 (TXB2) and hs-CRP were observed before and after treatment.

RESULTSAfter treatment the systolic blood pressure reduced and clinical symptoms improved, with serum NO and 6-keto-PGF(1alpha) lelels elevated, plasma ET-1, TXB2 and serum hs-CRP decreased in all the three groups (P<0.05 or P<0.01). But the inter-group comparisons showed that the effect in Group A was superior to the other two groups in decreasing systolic pressure, and superior to Group C in improving clinical symptoms, elevating serum NO and decreasing plasma TXB2 (P <0.05).

CONCLUSIONThe integrative medical regimen of combined use JYC and ND has markedly effect in lowering blood pressure, it could obviously improve the symptoms and vascular endothelial function, and inhibit the level of inflammatory factor in patients with EISH.

Aged ; C-Reactive Protein ; metabolism ; Double-Blind Method ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endothelin-1 ; blood ; Female ; Humans ; Hypertension ; drug therapy ; Integrative Medicine ; Male ; Middle Aged ; Nimodipine ; therapeutic use ; Nitric Oxide ; blood ; Phytotherapy ; Thromboxane B2 ; blood

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

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

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

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

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 observe the therapeutic effect of Yangxue Qingnao granule (YXQNG) in treating chronic cerebrovascular insufficiency (CCI) and its possible mechanism.

METHODSEighty-three patients with CCI were randomly divided into YXQNG and nimodipine (ND) groups, the score of vertigo and the change in cerebral blood velocity before and after treatment were observed. And in the animal experiment, the authors adopted bilateral ligation of cervical carotid communis artery to establish CCI rat models in order to observe the effect of YXQNG and ND on incubation period of vertigo in rats and on memory performance.

RESULTSAfter clinical treatment, the vertigo score of YXQNG group was 2.34, and that of the ND group was 4.18, the comparison between the two groups showed that the difference was significant (P < 0.05). After treatment, the middle cerebral artery mean velocity (MCA Vm) of YXQNG group was 64.78 cm/s, vertebral artery mean velocity (VA Vm) was 29.78 cm/s, while that of ND group was 60.34 cm/s and 23.23 cm/s respectively, the comparison between these two groups showing statistical significance and the difference being obvious (P < 0.05). Experimental study showed that the rats in the model group after 12 weeks learning and memory were markedly lowered, the vertigo incubation period significantly lengthened, and compared with that of the model group, learning and memory of the YXQNG group was markedly improved and vertigo incubation period shortened, with the difference from that of the ND group insignificant, P > 0.05.

CONCLUSIONYXQNG could effectively improve CCI patients' vertigo and other clinical symptoms and increase the cerebral blood flow, lessen the vertigo incubation of model group rats, elevate model group rats' memory performance.

Aged ; Aged, 80 and over ; Animals ; Blood Flow Velocity ; drug effects ; Cerebrovascular Circulation ; drug effects ; Cerebrovascular Disorders ; complications ; drug therapy ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Learning ; drug effects ; Male ; Memory ; drug effects ; Middle Aged ; Nimodipine ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Vasodilator Agents ; therapeutic use ; Vertigo ; etiology ; physiopathology

OBJECTIVETo explore the clinical efficacy of the principle of activating blood circulation to break stasis (ABCBS) and its influence on platelet membranous protein particle (GMP-140) and D(2) dimer (D-dimer) before and after treatment.

METHODSEighty-eight patients with blood stasis syndrome (BSS) of acute cerebral infarction (ACI) were randomly divided into two groups, both of which were treated with conventional treatment, i.e. with western medicine (WM), with Salvia injection added through intravenously dripping. One of the two groups was used as the control and the other group as the treated group who had ABCBS herbs orally taken in addition. The duration of treatment course for both groups was 3 weeks.

RESULTSThere were changes in both groups over clinical symptoms, nerve function deficit scoring and GMP-140, D-dimer, but the treated group showed significantly better than that of the control group, (P < 0.05).

CONCLUSIONABCBS principle could serve as an important auxiliary treating method for BSS of ACI, as it can effectively alter the blood of ACI patients which was viscous, condense, coagulant and aggregating.

Acute Disease ; Aged ; Aspirin ; therapeutic use ; Blood Circulation ; drug effects ; Blood Platelets ; metabolism ; Cerebral Infarction ; blood ; physiopathology ; therapy ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nervous System ; physiopathology ; Nimodipine ; therapeutic use ; P-Selectin ; blood ; Phytotherapy ; Plant Preparations ; therapeutic use ; Platelet Aggregation Inhibitors ; therapeutic use ; Salvia ; Vasodilator Agents ; therapeutic use