[Comparison of 2 consecutive series of aneurysmal subarachnoid hemorrhage with or without nimodipine and study of the temperature curve].
A total of 210 consecutive patients with aneurysmal subarachnoid hemorrhage (S.A.H.) of any clinical grade admitted from January 1985 through May 1990 were retrospectively studied to determine the effect of intravenous Nimodipine on survival and functional results and to analyse temperature curve as a prognosis factor. The 106 patients admitted from January 1985 through November 1987 constituted the reference series termed G1. The 104 patients admitted from December 1987 through May 1990 and treated with intravenous Nimodipine constituted the series termed G2. Of the 210 patients, 172 (82%) could be operated on with a similar mean operative delay in both series (G1 = 9.5 days, G2 = 9.8 days). Of the 210 patients, 153 (73%) survived with an average follow-up of 111 weeks for G1 and of 64 weeks for G2. Nimodipine treatment was associated with a significant increase of survival (11.8%, P = 0.05) which was not the result of improved operative technique but of a lower incidence of deaths caused by postoperative vasospasm (G1 = 5 deaths, G2 = 0 deaths, P = 0.05) and by rebleeding (G1 = 15 deaths, G2 = 5 deaths, P = 0.03). No significant difference between the two series G1 and G2 was observed regarding functional results in the 153 survivors, frequency and seriousness of clinical signs of vasospasm during the waiting phase for surgery, radiologic signs of vasospasm on initial and second angiography, cerebral infarctus on second C.T.-Scan. Analysis of temperature curves of the 210 patients revealed that a delayed fever with a plateau pattern was associated with a higher incidence of vasospasm, rebleeding, and deaths.(ABSTRACT TRUNCATED AT 250 WORDS)
Rousseaux
P
P
Service de Neurochirurgie, Hôpital Maison Blanche, C.H.U., Reims.
Gomis
P
P
Bazin
A
A
Peruzzi
P
P
Scherpereel
B
B
Bernard
M H
MH
Bertault
R
R
Graftieaux
J P
JP
D000328:Adult; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D002546:Ischemic Attack, Transient / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D016019:Survival Analysis; D013696:Temperature
D009553:Nimodipine
Comparaison de deux séries consécutives d'hémorragies méningées anévrysmales avec et sans nimodipine et étude de la coubre thermique.