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

Abstract

Vasospasm (VSP) is one of the major causes for prolonged neurologic deficit in patients with aneurysmal subarachnoid hemorrhage. Few case series have reported about continuous local intra-arterial nimodipine administration (CLINA) in refractory VSP. We report our experience with CLINA in a patient with refractory cerebral VSP.

Keywords

aneurysmal subarachnoid hemorrhage - intra-arterial nimodipine - transcranial color-coded sonography - vasospasm

• References

• 1 Kassell NF, Sasaki T, Colohan AR, Nazar G. Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke 1985; 16 (4) 562-572
• 2 Brisman JL, Eskridge JM, Newell DW. Neurointerventional treatment of vasospasm. Neurol Res 2006; 28 (7) 769-776
• 3 Dorhout Mees SM, Rinkel GJ, Feigin VL , et al. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev 2007; 18 (3) CD000277
• 4 Biondi A, Ricciardi GK, Puybasset L , et al. Intra-arterial nimodipine for the treatment of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage: preliminary results. AJNR Am J Neuroradiol 2004; 25 (6) 1067-1076
• 5 Mayer TE, Dichgans M, Straube A , et al. Continuous intra-arterial nimodipine for the treatment of cerebral vasospasm. Cardiovasc Intervent Radiol 2008; 31 (6) 1200-1204
• 6 Musahl C, Henkes H, Vajda Z, Coburger J, Hopf N. Continuous local intra-arterial nimodipine administration in severe symptomatic vasospasm after subarachnoid hemorrhage. Neurosurgery 2011; 68 (6) 1541-1547; discussion 1547
• 7 Ott S, Jedlicka S, Wolf S , et al. Continuous selective intra-arterial application of nimodipine in refractory cerebral vasospasm due to aneurysmal subarachnoid hemorrhage. Biomed Res Int 2014; 2014: 970741
• 8 Wolf S, Martin H, Landscheidt JF, Rodiek SO, Schürer L, Lumenta CB. Continuous selective intraarterial infusion of nimodipine for therapy of refractory cerebral vasospasm. Neurocrit Care 2010; 12 (3) 346-351
• 9 Anand S, Goel G, Gupta V. Continuous intra-arterial dilatation with nimodipine and milrinone for refractory cerebral vasospasm. J Neurosurg Anesthesiol 2014; 26 (1) 92-93
• 10 Doukas A, Petridis AK, Barth H, Jansen O, Maslehaty H, Mehdorn HM. Resistant vasospasm in subarachnoid hemorrhage treated with continuous intraarterial nimodipine infusion. Acta Neurochir Suppl (Wien) 2011; 112: 93-96
• 11 Lysakowski C, Walder B, Costanza MC, Tramèr MR. Transcranial Doppler versus angiography in patients with vasospasm due to a ruptured cerebral aneurysm: a systematic review. Stroke 2001; 32 (10) 2292-2298
• 12 Diringer MN, Bleck TP, Claude Hemphill III J , et al; Neurocritical Care Society. Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference. Neurocrit Care 2011; 15 (2) 211-240
• 13 Sloan MA, Alexandrov AV, Tegeler CH , et al; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: transcranial Doppler ultrasonography: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2004; 62 (9) 1468-1481