Continuous intra-arterial infusion of nimodipine at the onset of resistant vasospasm in aneurysmal subarachnoidal haemorrhage. Technical report.
Cerebral vasospasm complicating the aneurysmal subarachnoid haemorrhage is a well known medical entity. The delayed ischemic neurological deficits (DINDs) as a result of vasospasm, remain the main cause of morbidity among patients who manage to survive this severe disease pattern. When the traditional treatment options either medical or interventional, fail to reverse the vasospasm, continuous intra-arterial infusion of nimodipine through catheters direct in the spastic arteries, presents a promising treatment modality. We treated in our clinic four patients with severe aneurysmal subarachnoid haemorrhage and refractory vasospasms with continuous nimodipine infusion via catheters in both internal carotid arteries and discussed the efficacy of the method presenting an illustrative case and discussing the effect based on doppler examinations.
Doukas
Alexandros
A
Department of Neurosurgery, University Hospital of Schleswig-Holstein, Campus Kiel, Germany. axlpam@googlemail.com
Petridis
Athanasios Konstantinou
AK
Barth
Harald
H
Jansen
Olav
O
Mehdorn
Hubertus Maximilian
HM
D000959:Antihypertensive Agents / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000008:administration & dosage*; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013997:Time Factors; D020301:Vasospasm, Intracranial / Q000188:drug therapy* / Q000209:etiology*
D000959:Antihypertensive Agents; D009553:Nimodipine