Comparison of nimodipine delivery routes in cerebral vasospasm after subarachnoid hemorrhage: an experimental study in rabbits.
BACKGROUND
nimodipine is the most widely preferred and administered calcium channel blocker in cerebral vasospasm prevention and treatment. There is no experimental or clinical study investigating the comparative effects of routine treatment modalities.


METHODS
35 male New Zealand White rabbits were assigned randomly to one of seven groups: Control, only SAH, SAH/oral nimodipine, SAH/IV nimodipine, SAH/IT nimodipine, SAH/IA nimodipine, SAH/angiography.


RESULTS
basilar artery vessel diameters are measured by angiography. Basilar artery vessel diameters and luminal sectional areas are measured in pathology slides. Basilar artery thicknesses were significantly higher in group 2 and 7 than the others (p < 0.05). Luminal sectional areas in group 5 and 6 were significantly higher than other groups (p < 0.05). We found no significant difference in group 1, 5 and 6 (p > 0.05). Basilar section areas in group 3 and 4 were significantly higher than group 2 but lower than group 1.


CONCLUSIONS
this is the first study to show the most effective drug delivery route in CVS after SAH. Nimodipine treatment in cerebral vasospasm is useful. This study showed that selective IA nimodipine treatment and IT nimodipine treatment must be preferred to IV and oral treatments of chronic vasospasm following SAH.
Department of Neurosurgery, Gulhane Military Academy, Ugur Mumcunun Sokak, 78/2, 06700, Gaziosmanpasa, Ankara, Turkey.
Mehmet Bulent
MB
Onal
Erdinc
E
Civelek
Atilla
A
Kircelli
Ilker
I
Solmaz
Sahin
S
Ugurel
Firat
F
Narin
Ilkay
I
Isikay
Burcak
B
Bilginer
Hakan
H
Yakupoglu
D000284:Administration, Oral; D000704:Analysis of Variance; D015901:Angiography, Digital Subtraction / Q000379:methods; D000818:Animals; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000473:pathology; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D004195:Disease Models, Animal; D016503:Drug Delivery Systems / Q000379:methods*; D007269:Injections, Intra-Arterial / Q000379:methods; D007275:Injections, Intravenous / Q000379:methods; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D009553:Nimodipine / Q000008:administration & dosage*; D011817:Rabbits; D013345:Subarachnoid Hemorrhage / Q000150:complications; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*
D002121:Calcium Channel Blockers; D009553:Nimodipine