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Lee, Choi, Son, Ryu, Shin, Choi, Chung, and You: Effect of Intra-Arterial Nimodipine Infusion for the Treatment of Symptomatic Cerebral Vasospasm Following an Aneurysmal Subarachnoid Hemorrhage
Original Article
Neuroradiology
Journal of the Korean Society of Radiology

Journal of the Korean Society of Radiology 2012; 66(6): 501-506.

Published online: 13 June 2012

DOI: https://doi.org/10.0000/jksr.2012.66.6.501

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

Jin Young Lee, MD1, Dae Seob Choi, MD1, 2, Seungnam Son, MD3, Jae Wook Ryu, MD4, Hwa Seon Shin, MD1, Hye Young Choi, MD1, Sung Hoon Chung, MD1, Jin Jong You, MD1

1Department of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

2Gyeongsang Institute of Health Science, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

3Department of Neurology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.

4Department of Radiology, Samsung Seoul Hospital, Seoul, Korea.

Corresponding author: Jin Jong You, MD. Department of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju 660-702, Korea. Tel. 82-55-750-8211, Fax. 82-55-758-1568, bgbampi@gmail.com

Received 11 December 2011       Accepted 14 April 2012

Copyright © 2012 The Korean Society of Radiology

Abstract

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.

Keywords: Vasospasm, Intracranial, Subarachnoid Hemorrhage, Nimodipine, Intra-arterial Infusion

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