Korean J Cerebrovasc Surg.  2005 Sep;7(3):218-223.

Intra-arterial Nimodipine for the Treatment of Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage : Preliminary Report Clinical Research

• Lee JW
• Kim KH
• Ahn SK

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.

Keyword

Subarachnoid hemorrhage; Symptomatic cerebral vasospasm; Intra-arterial nimodipine

MeSH Terms

Aneurysm*
Angiography
Basilar Artery
Carotid Artery, Internal
Cerebral Angiography
Dilatation
Follow-Up Studies
Humans
Nimodipine*
Subarachnoid Hemorrhage*
Vasodilation
Vasospasm, Intracranial*
Nimodipine