title: Resistant vasospasm in subarachnoid hemorrhage treated with continuous intraarterial nimodipine infusion.
abstract: Cerebral vasospasm complicating aneurysmal subarachnoid hemorrhage is a well-known medical entity. The delayed ischemic neurological deficits (DIND) 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 vasospasm, continuous intraarterial infusion of nimodipine through catheters directly into the spastic arteries presents a promising treatment modality. Of 73 patients with aneurysmal subarachnoid hemorrhage between 2008 and 2009, a total of 27 had Hunt and Hess grades of 4 and 5. Fifteen percent of them showed refractory vasospasms and were treated with continuous nimodipine infusion via catheters in both internal carotid arteries. We present the method's indications and possible complications.
authors.affiliation: Department of Neurosurgery, University Hospital of Schleswig-Holstein, Kiel, Germany. axlpam@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Doukas
authors.forename: A K
authors.initials: AK
authors.lastname: Petridis
authors.forename: H
authors.initials: H
authors.lastname: Barth
authors.forename: O
authors.initials: O
authors.lastname: Jansen
authors.forename: H
authors.initials: H
authors.lastname: Maslehaty
authors.forename: H M
authors.initials: HM
authors.lastname: Mehdorn
mesh_terms: D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D002533:Cerebral Angiography; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D009553:Nimodipine / Q000008:administration & dosage*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications; D014057:Tomography, X-Ray Computed / Q000379:methods; D020301:Vasospasm, Intracranial / Q000188:drug therapy* / Q000209:etiology
chemical_list: D002121:Calcium Channel Blockers; D009553:Nimodipine