Cerebral Vasospasm and Calcium Channel Blockade. Nimodipine treatment in patients with aneurysmal subarachnoid hemorrhage

In patients with aneurysmal subarachnoid hemorrhage (SAH), delayed ischemic cerebral dysfunction (DID or symptomatic vasospasm) with subsequent fixed neurological dysfunction (FND) is a frequent and most feared complication induced by the hemorrhage. Aneurysm operation during the acute stage with intraoperative evacuation of bloodcontaminated cerebrospinal fluid (CSF) from the basal cisterns and subarachnoid spaces has reduced this complication. Nevertheless despite early operation, DID with FND occurs in 13-20% or more. In a series of 100 individuals with a ruptured supratentorial aneurysm, who were subjected to aneurysm operation in the acute stage and who subsequently received intravenous treatment with the calcium channel blocker nimodipine, the occurrence of DID with FND was reduced to 5%.