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KMID : 1005420050070030218
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Journal of Cerebrovascular and Endovascular Neurosurgery
2005 Volume.7 No. 3 p.218 ~ p.223
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Intra-arterial Nimodipine for the Treatment of Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage : Preliminary Report Clinical Research
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Lee Jae-Won
Kim Keon-Ha
Ahn Sung-Ki
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Abstract
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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.
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KEYWORD
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Subarachnoid hemorrhage, Symptomatic cerebral vasospasm, Intra-arterial nimodipine
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