Intra-Arterial Nimodipine Infusion for Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage

Abstract

<jats:p> This study evaluated the efficacy of intra-arterial nimodipine infusion for symptomatic vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH). Clinical data collected from 42 consecutive patients with symptomatic vasospasm after aSAH were retrospectively reviewed. Forty-two patients underwent 101 sessions of intra-arterial nimodipine infusion. Angiographic response, immediate clinical response, and clinical outcome were evaluated at discharge and six months later. </jats:p><jats:p> Angiographic improvement was achieved in 82.2% of patients. The immediate clinical improvement rate was 68.3%, while the deterioration rate was 5.0%. A favorable clinical outcome was achieved in 76.2% at discharge and 84.6% six months. Vasospasm-related infarction occurred in 21.4%. There was no drug-related complication. The nimodipine group showed satisfactory outcomes. Nimodipine can be recommended as an effective and safe intra-arterial agent for the treatment of symptomatic vasospasm after aSAH. </jats:p>

Salvinorin A ameliorates cerebral vasospasm through activation of endothelial nitric oxide synthase in a rat model of subarachnoid hemorrhage

“…Intra‐arterial infusion of nimodipine or nicardipine as calcium blocker to dilate vessels is used in clinical practice for symptomatic vasospasm . However, only a small portion of patients could respond to nimodipine or nicardipine.…”

“…to dilate vessels is used in clinical practice for symptomatic vasospasm. 28 However, only a small portion of patients could respond to nimodipine or nicardipine. This procedure may induce the risk of thromboembolism.…”

Aneurysmal Subarachnoid Hemorrhage

“…Transluminal angioplasty and injection of intra-arterial nimodipine proximal to a vasospastic vessel improves clinical outcome as observed in small case studies. [231][232][233][234][235][236] Balloon angioplasty along with intra-arterial nicardipine is also found to be useful in the management of refractory vasospasm. 227,237 Intra-arterial milrinone has also shown benefit in small case studies.…”

Comparison of the effects and mechanism of the curcumin with different acting drugs in experimental vasospasm after subarachnoid hemorrhage

“…In this group of animals, TUNEL-positive cells were mostly found in neuroglia cells. Nimodipine is an effective and safe treatment for symptomatic vasospasm after SAH (6,20). Regional administration of the drug has a potent vasodilatory effect even in low doses.…”