Continuous Local Intra-Arterial Nimodipine for the Treatment of Cerebral Vasospasm

Logallo, Nicola; Bøthun, Marianne Lundervik; Guttormsen, Anne Berit; Holmaas, Gunhild; Kråkenes, Jostein; Thomassen, Lars; Svendsen, Frode; Helland, Christian A.

doi:10.1055/s-0034-1543976

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…23 A clinical study in intensive care unit found that 23% of the patients had improvement of neurological deficits and 83% had good clinical condition and this therapy can be considered as a low risk of treatment for refractory vasospasm. 24,25 Local IA nimodipine is also a high safety procedure and gives improvement in vasospasm; nevertheless there are some limitations such as there are no guidelines about selection of patients, duration of treatment or dosage of nimodipine.…”

Section: B Nimodipinementioning

confidence: 99%

Management of cerebral vasospasm in subarachnoid hemorrhage

Prahaztuti

Hidayati

Sani

2019

APIC

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Subarachnoid hemorrhage (SAH) has been shown to result in cerebral vasospasm at day 4 to day 14, which is the main cause of mortality and morbidity after SAH. Outcome after SAH depends on many factors, including the severity of the event, medical management, and prevention of several serious complications. The principal goal in management of vasospasm after SAH is to prevent delayed ischemic neurological deficit (DIND) by decreasing intracranial pressure (ICP), optimizing cerebral oxygen demand rate and improving cerebral blood flow (CBF). Therapeutic management has been applied to prevent or treat vasospasm, including hemodynamic therapy, and endovascular therapy. Endovascular therapies, including mechanical angioplasty and chemical angioplasty with administration of intra-arterial (IA) vasodilator, have been widely used and given a good outcome. The purpose of this article is to describe the management of vasospasm including medical management and endovascular treatment. This review will describe the treatment modalities and management strategies to treat vasospasm.Abbreviations: SAH – subarachnoid hemorrhage; aSAH – aneurysmal subarachnoid hemorrhage; TCD – transcranial Doppler; ROS – reactive oxygen species; ICAM – intercellular adhesion molecule; VCAM – vascular cell adhesion molecule; IL – interleukin; CTA – computed tomography angiography; MRA – magnetic resonance angiography; CBF – cerebral blood flow; DIND – delayed ischemic neurological deficit; RCT - randomized controlled trialsCitation: Prahaztuti D, Hidayati HB, Sani AF. Management of cerebral vasospasm in subarachnoid hemorrhage. Anaesth Pain & Intensive Care 2018;22(3 Suppl 1):S58-S66.Received: 19 Oct 2018 Reviewed: 4, 11 Nov 2018 Accepted: 12 Nov 2018

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Section: B Nimodipinementioning

confidence: 99%

Management of cerebral vasospasm in subarachnoid hemorrhage

Prahaztuti

Hidayati

Sani

2019

APIC

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Chemical angioplasty with spasmolytics for vasospasm after subarachnoid hemorrhage

Hejčl¹,

Cihlář

Smolka

et al. 2017

Acta Neurochir

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Intra-arterial administration of spasmolytics is a safe and potent method of vasospasm treatment. It is most effective when applied to conscious patients with a focal deficit. For unconscious patients, its therapeutic benefits are inconclusive. Patients in severe clinical states would further require use of other diagnostic tools such as multimodal brain monitoring to complement vasospasm therapy.

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Chemical angioplasty for cerebral vasospasm in patients with subarachnoid hemorrhage

Шилов

Миронов

Uchasova

et al. 2019

Kompleks. probl. serdečno-sosud. zabol.

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Aim. To evaluate the hospital outcomes of chemical angioplasty in patients with vasospasm secondary to the clipping of the ruptured cerebral artery aneurysm.Methods. 18 patients who underwent chemical angioplasty were included in the study. Patients’ age ranged from 24 to 66 years old, the mean age was 46.6±13.2 years. Indications for chemical angioplasty and the criteria for its termination were determined by the neurosurgeon based on clinical signs and symptoms, and the data of the non-invasive examination.Results.The sessions of chemical angioplasty were performed an average of 4.7±2.3 days after the aneurysm clipping and 6.5±3 days after the onset of subarachnoid hemorrhage. The number of sessions was 4.8±2.2 and varied from 1 to 9 sessions. The baseline Lindergard index was 3.82±0.6. Three patients (16.6%) died in the in-hospital period. The Lindergard index after the end of chemical angioplasty was 2.75±0.84, which is unreliably lower (p = 0.31) than that at the baseline.Conclusion. Timely chemical angioplasty can reduce the development of significant vasospasm complications, particularly ischemic neurologic deficit.

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Continuous Local Intra-Arterial Nimodipine for the Treatment of Cerebral Vasospasm

Cited by 5 publications

References 13 publications

Management of cerebral vasospasm in subarachnoid hemorrhage

Management of cerebral vasospasm in subarachnoid hemorrhage

Chemical angioplasty with spasmolytics for vasospasm after subarachnoid hemorrhage

Chemical angioplasty for cerebral vasospasm in patients with subarachnoid hemorrhage

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