Efficacy Of Nimodipine Intracisternal Administration For The Prevention Of Cerebral Vasospasm After Subarachnoid Hemorrhage

Objective:To investigate the Efficacy and safety of NimodipineIntracisternal Administration for the Prevention of Cerebral Vasospasm AfterSubarachnoid Hemorrhage in order to provide a new treatment.Methods：Forty patients with SAH were treated by surgical clipping, andrandomly divided into two groups:1) the control group (n=20) treated onlywith baseline treatment include Intravenous drug therapy and continuouslumbar CSF drainage;2) the treatment group (n=20) received intermittenNimodipine Intracisternal Administration (concentration:0.01mg/ml)。Thetreatment groups received continuous irrigation using Nimodipine solutioninfused at20mL/hr for48hours. The clearance of subarachnoid clots wasmeasured by laboratory examinations and postoperative computed tomography.Ischemia-related vasospasm was evaluated by neurological status, computedtomography and TCD examination. Neurological outcome was evaluated bythe modified Rankin scale at3months after onset.Results：The subarachnoid clot was efficiently and significantly removedwithout major complication in the treatment groups (P <0.05). The incidenceof ischemic lesion in the intermittent group was significantly lower than in thecontrol group (P <0.05). The treatment group had significantly betterneurological outcome than the control group (P <0.05).Conclusion：Cisternal irrigation therapy using Nimodipine is effectiveand safe. Intermittent injection is most effective and may decrease the risk ofsymptomatic vasospasm in patients with SAH.