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J Korean Soc Radiol.  2012 Jun;66(6):501-506. 10.3348/jksr.2012.66.6.501.

Effect of Intra-Arterial Nimodipine Infusion for the Treatment of Symptomatic Cerebral Vasospasm Following an Aneurysmal Subarachnoid Hemorrhage

Affiliations
  • 1Department of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea. bgbampi@gmail.com
  • 2Gyeongsang Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 3Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 4Department of Radiology, Samsung Seoul Hospital, Seoul, Korea.

Abstract

PURPOSE
Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm.
MATERIALS AND METHODS
Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes.
RESULTS
In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3) were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS.
CONCLUSION
IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed.


MeSH Terms

Aneurysm
Catheterization
Catheters
Glasgow Outcome Scale
Glycosaminoglycans
Humans
Infusions, Intra-Arterial
Nimodipine
Retrospective Studies
Subarachnoid Hemorrhage
Vasospasm, Intracranial
Glycosaminoglycans
Nimodipine
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