Effect of Intra-Arterial Nimodipine Infusion for the Treatment of Symptomatic Cerebral Vasospasm Following an Aneurysmal Subarachnoid Hemorrhage

Abstract

Copyrights © 2012 The Korean Society of Radiology Purpose: Symptomatic cerebral vasospasm following an aneurysmal subarachnoid hemorrhage (SAH) is one of the major factors which cause morbidity and mortality of patients. The purpose of this study was to evaluate the effectiveness of intra-arterial nimodipine (IAN) infusion therapy in patients with symptomatic cerebral vasospasm. Materials and Methods: Between February 2005 and April 2011, fifty patients with symptomatic cerebral vasospasm following an aneurysmal SAH were treated with IAN infusion. After selective arterial catheterization, nimodipine was infused at a rate of 0.1 mg/min and a total of 2-3 mg per vessel was infused. We retrospectively reviewed the immediate angiographic results and clinical outcome at discharge. A grade of 5 and 4 in the Glasgow Outcome Scale (GOS) were considered favorable outcomes. Results: In 50 patients, 117 procedures of IAN infusion (1-7; mean, 2.3) were done. After the treatment, immediate angiographic improvement was achieved in 113 (96.6%) of 117 procedures. No major complications occurred. At discharge, 38 (76%) patients showed a favorable clinical outcome in the GOS. Conclusion: IAN infusion therapy is safe and effective for the treatment of cerebral vasospasm following an aneurysmal SAH. However, the limitation is that repeated treatment is needed. Index terms Vasospasm, Intracranial Subarachnoid Hemorrhage Nimodipine Intra-arterial Infusion Effect of Intra-Arterial Nimodipine Infusion for the Treatment of Symptomatic Cerebral Vasospasm Following an Aneurysmal Subarachnoid Hemorrhage 동맥류성 지주막하출혈 후 발생한 뇌혈관연축의 동맥 내 니모디핀 주입술의 효과