Immediate postangiographic intraarterial treatment of cerebral vasospasm after subarachnoid hemorrhage with nimodipine: Report on 3 cases

Abstract

Three cases of symptomatic vasospasm after spontaneous subarachnoid hemorrhage are reported. Vasospasm occurred preoperatively in two instances and postoperatively in another. All three cases received an intraarterial perfusion with 0.2 mg nimodipine (BAY e 9736) per hour for 90 minutes. Resolution of the spasms was demonstrated by angiography. As there were no side effects attributable to this form of treatment, new possibilities for neuroradiological intervention may arise in selected cases.

Intra-Arterial Nimodipine for Severe Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Influence on Clinical Course and Cerebral Perfusion

“…37 IAN in patients with severe vasospasm has been reported by several authors. [24][25][26] Data from a larger series by Biondi et al 18 demonstrated that IAN is effective and safe for the treatment of vasospasm after SAH. In this trial, 25 patients treated The present study completes the examination of the effectiveness of IAN by additionally investigating the cerebral perfusion by means of repeated PCT.…”

“…23 Intra-arterial nimodipine (IAN) in patients with severe vasospasm has been reported by several authors. [24][25][26] Data from a larger series by Biondi et al 18 suggested that IAN is effective and safe for the treatment of vasospasm after SAH. However, no information regarding the influence of IAN on cerebral perfusion is available.…”

Intraarterial Nimodipine Infusion to Treat Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

“…Infusing intraarterial nimodipine in patients with symptomatic vasospasm has been reported on by several authors. Two early clinical studies have presented conflicting results 3,8) . Boker et al 3) reported on the use of selective intraarterial nimodipine infusion for treating three patients with vasospasm following aneurysmal SAH, and they concluded that intraarterial nimodipine was angiographically effective.…”

“…Two early clinical studies have presented conflicting results 3,8) . Boker et al 3) reported on the use of selective intraarterial nimodipine infusion for treating three patients with vasospasm following aneurysmal SAH, and they concluded that intraarterial nimodipine was angiographically effective. Grotenhuis et al 8) treated six patients with intraarterial nimodipine (0.068-1 mg); however, the treatment was ineffective when administered after the onset of vasospasm.…”

Intraarterial nimodipine for the treatment of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage: A preliminary study

“…[21] IA nimodipine has been used in a few clinical settings, and is shown to be effective and safe for the treatment of symptomatic vasospasm after SAH. [22][23][24] We started the use of nimodipine for patients with cerebral vasospasm either as an adjunct therapy to angioplasty or as the sole treatment depending on the angiographical and angioanatomical situation. This preliminary study was designed to assess the safety and efficacy of this treatment.…”