Angiographic features and clinical outcomes of intra-arterial nimodipine injection in patients with subarachnoid hemorrhage-induced vasospasm

Sang Shin Kim, Dong Hyuk Park, Dong Jun Lim, Shin Hyuk Kang, Tai Hyoung Cho, Yong Gu Chung

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)

    Abstract

    Objective: The aim of this study was to determine the role of intra-arterial (IA) nimodipine injections for cerebral vasospasm secondary to ruptured subarachnoid hemorrhage (SAH) and to investigate the factors that influence vasodilation and clinical outcomes. Methods: We enrolled 29 patients who underwent aneurysm clipping for ruptured cerebral aneurysms between 2009 and 2011, and who received IA nimodipine after subsequently presenting with symptomatic vasospasm. The degree of vasodilation shown in angiography was measured, and the correlation between the degree of vasodilation and both the interval from SAH to cerebral vasospasm and the interval from clipping to cerebral vasospasm was determined. The change in blood flow rate after IA injection was assessed by transcranial Doppler ultrasound. Multiple clinical parameters were completed before and after IA nimodipine injection to evaluate any improvements in clinical symptoms. Results: For eight patients, Glasgow Coma Scale (GCS) scores increased by two or more points. The regression analysis demonstrated a positive correlation between the change in GCS scores after IA nimodipine injection and the change in blood vessel diameter (p=0.025). A positive correlation was also observed between the interval from SAH to vasospasm and the change in diameter (p=0.040); and the interval from clipping to vaso-spasm and the change in diameter (p=0.022). Conclusion: IA nimodipine injection for SAH-induced vasospasm led to significant vasodilation in angiography and improvement in clinical symptoms without significant complications. Our fndings suggest that IA nimodipine injection should be utilized when intractable vasospasm develops despite rigorous conservative management.

    Original languageEnglish
    Pages (from-to)172-178
    Number of pages7
    JournalJournal of Korean Neurosurgical Society
    Volume52
    Issue number3
    DOIs
    Publication statusPublished - 2012 Sep

    Keywords

    • Cerebral angiograms
    • Intra-arterial injection
    • Nimodipine
    • Ruptured aneurysm
    • Subarachnoid hemorrhage
    • Vasospasm

    ASJC Scopus subject areas

    • Surgery
    • Neuroscience(all)
    • Clinical Neurology

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