Early aneurysm surgery and preventive therapy with intravenously administered nimodipine: a multicenter, double-blind, dose-comparison study.
A European, multicenter, prospective, randomized, double-blind, dose-comparison study on preventive therapy with intravenously administered nimodipine was performed to evaluate the efficacy and tolerability of two different doses: 2 and 3 mg/h. Two hundred four patients fulfilled the criteria for enrollment in the study: surgery within 72 hours after the last subarachnoid hemorrhage, and age between 16 and 72 years. All patients who had Hunt and Hess grades of I to III were operated upon; patients who had poor Hunt and Hess grades (IV-V) were operated on according to the surgeon's choice. This treatment regimen was associated with a low incidence of delayed neurological dysfunction with no significant difference between the two dosage groups: three patients (1.5%) remained severely disabled and two (1%) moderately disabled due to vasospasm with or without additional complications. Among the patients with Hunt and Hess grades of IV or V, the long-term outcome was favorable (good-fair) for 40% and unfavorable for 60%. Among the patients with grades of I to III, the long-term outcome was favorable for 89% and unfavorable for 11%.
Gilsbach
J M
JM
Department of Neurosurgery, University of Technology Medical School, Aachen, Federal Republic of Germany.
Reulen
H J
HJ
Ljunggren
B
B
Brandt
L
L
von Holst
H
H
Mokry
M
M
von Essen
C
C
Conzen
M A
MA
D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D002532:Intracranial Aneurysm / Q000188:drug therapy / Q000517:prevention & control / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009553:Nimodipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D009553:Nimodipine