Outcome of Nimodipine Treatment on the Surgical Cases of Aneurysmal Subarachnoid Hemorrhage

Lee, Sang Hyung; Han, Dae Hee

Abstract

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