Document Detail


Use of intrathecal nicardipine for aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm.
MedLine Citation:
PMID:  19139684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cerebral vasospasm leading to delayed ischemia is a common and serious complication of aneurysmal subarachnoid hemorrhage that often results in increased morbidity and mortality. Treatments for cerebral vasospasm, including triple-H therapy (therapeutic hypervolemia, hypertension, and hemodilution), nimodipine, balloon angioplasty, and intra-arterial vasodilators have limitations in their efficacy and safety profiles. Nicardipine, a calcium channel blocker, is available for intravenous administration for blood pressure reduction. A recent study reported its efficacy in the treatment of cerebral vasospasm when given intrathecally (IT). We present our experiences with IT nicardipine for treatment of cerebral vasospasm. METHODS: IT nicardipine was administered to six patients with aneurysmal subarachnoid hemorrhage after prophylactic and aggressive therapeutic management for vasospasm failed. RESULTS: In these patients, IT nicardipine treatment was followed within 8 hours by a 43.1 +/- 31.0 cm/s decrease in middle cerebral arterial flow velocity, as measured by transcranial Doppler ultrasound. CONCLUSIONS: Based on these positive results, we believe that larger scale studies evaluating the safety and efficacy of IT nicardipine for the management of cerebral vasospasm are warranted.
Authors:
As'ad Ehtisham; Scott Taylor; Linda Bayless; Owen B Samuels; Michael W Klein; Jeff M Janzen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  102     ISSN:  1541-8243     ISO Abbreviation:  South. Med. J.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-10     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-3     Citation Subset:  AIM; IM    
Affiliation:
Neuroscience Critical Care Unit, Via Christi Regional Medical Center, University of Kansas School of Medicine, Wichita, KS 67214, USA. aehtisham@kumc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Calcium Channel Blockers / administration & dosage,  therapeutic use*
Female
Humans
Injections, Spinal
Male
Middle Aged
Nicardipine / administration & dosage,  therapeutic use*
Subarachnoid Hemorrhage / complications,  drug therapy*
Vasospasm, Intracranial / drug therapy*,  etiology
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 55985-32-5/Nicardipine

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


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