Document Detail


Nimodipine in aneurysmal subarachnoid hemorrhage: a randomized study of intravenous or peroral administration.
MedLine Citation:
PMID:  18847340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The calcium antagonist nimodipine has been shown to reduce the incidence of ischemic complications following aneurysmal subarachnoid hemorrhage (SAH). Although most randomized studies have been focused on the effect of the peroral administration of nimodipine, intravenous infusion is an alternative and the preferred mode of treatment in many centers. It is unknown whether the route of administration is of any importance for the clinical efficacy of the drug. METHODS: One hundred six patients with acute aneurysmal SAH were randomized to receive either peroral or intravenous nimodipine treatment. The patients were monitored for at least 10 days after bleeding in terms of delayed ischemic neurological deficits (DINDs) and with daily measurements of blood flow velocities in the middle cerebral arteries by using transcranial Doppler ultrasonography. Three months after SAH, clinical outcome and new cerebral infarctions according to MR imaging studies were recorded. RESULTS: Baseline characteristics (age, sex distribution, clinical status on admission, radiological findings, and aneurysm treatment) did not differ between the treatment groups. There was no significant difference in the incidence of DINDs (28 vs 30% in the peroral and intravenous groups, respectively) or middle cerebral artery blood flow velocities (> 120 cm/second, 50 vs 45%, respectively). Clinical outcome according to the Glasgow Outcome Scale was the same in both groups, and there was no difference in the number of patients with new infarctions on MR imaging. CONCLUSIONS: The results suggest that there is no clinically relevant difference in efficacy between peroral and intravenous administration of nimodipine in preventing DINDs or cerebral vasospasm following SAH.
Authors:
Erik Kronvall; Per Undrén; Bertil Romner; Hans Säveland; Mats Cronqvist; Ola G Nilsson
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  110     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-05     Completed Date:  2009-02-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  58-63     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Lund University Hospital, Lund, Sweden. erik.kronvall@med.lu.se
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Calcium Channel Blockers / administration & dosage,  therapeutic use*
Endpoint Determination
Female
Follow-Up Studies
Glasgow Coma Scale
Humans
Injections, Intravenous
Magnetic Resonance Imaging
Male
Middle Aged
Nimodipine / administration & dosage,  therapeutic use*
Prospective Studies
Subarachnoid Hemorrhage / drug therapy*,  radiography,  ultrasonography
Tomography, X-Ray Computed
Treatment Outcome
Vasospasm, Intracranial / etiology,  prevention & control
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 66085-59-4/Nimodipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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