Efficacy of intra-arterial nimodipine therapy in the treatment of vasospasm after subarachnoid hemorrhage

Abstract

Background: This study aims to investigate the efficacy of intra-arterial nimodipine therapy in treating patients that presented with spontaneous subarachnoid hemorrhage and developed vasospasm following aneurysm surgery. Methods: The study includes 37 patients that underwent intra-arterial nimodipine therapy for the treatment of cerebral vasospasm between October 2015 and December 2019. In patients that developed vasospasm, a catheter was selectively inserted into the internal carotid artery, 1–2 mg of nimodipine was diluted with 50 ccs of saline, and was slowly infused through the catheter. Results: In our study, we found the success rate of intra-arterial nimodipine administration to be 78.4% (neurologic findings completely improved in 29 cases). The clinical condition did not improve in 13.5% of cases and worsened in 8.1%. 86.4% of our patients were discharged with good outcomes (mRS score 0–1). Conclusion: We conclude that intra-arterial nimodipine therapy is a cost-effective, safe, and successful method for the treatment of cerebral vasospasm, a condition that directly affects morbidity and mortality after subarachnoid hemorrhage. Prospective studies are needed to determine standard doses and application times in order to establish the efficacy of intra-arterial nimodipine therapy in treating cerebral vasospasm.

Keywords

• spontaneous subarachnoid hemorrhage