In order to elucidate the clinical effectiveness of nimodipine treatment, we anayzed 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 eighy patients (55.9%) treated without nimodipine during this period. The patients were randomly allocated to
either
group. The nimodipine was infused intravenously at 30ug/Kg/hr for the first week beginning on the day of admission and then given orally at 360mg/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, motality and morbidity,
and
mortality due to delayed ischemic deficits were not sigificantly different (P>005, 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 groups (p>0.05), respectively.
Nimodipine treatment did not improve the rate of good outcome in the aneurysmal subarachnoid hemorrhage in our study.
|