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Nimodipine in aneurysmal subarachnoid hemorrhage: a randomized study of intravenous or peroral administration.

Kronvall, Erik LU ; Undrén, Per; Romner, Bertil LU ; Säveland, Hans LU ; Cronqvist, Mats LU and Nilsson, Ola LU (2009) In Journal of Neurosurgery 110. p.58-63
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Neurosurgery
volume
110
pages
58 - 63
publisher
American Association of Neurosurgeons
external identifiers
  • wos:000262016200010
  • pmid:18847340
  • scopus:60749127288
ISSN
0022-3085
DOI
10.3171/2008.7.JNS08178
language
English
LU publication?
yes
id
3a1bda80-47f8-46e5-99f6-2c2559f58ca2 (old id 1262319)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18847340?dopt=Abstract
date added to LUP
2008-11-05 14:08:50
date last changed
2017-10-08 04:32:21
@article{3a1bda80-47f8-46e5-99f6-2c2559f58ca2,
  abstract     = {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.},
  author       = {Kronvall, Erik and Undrén, Per and Romner, Bertil and Säveland, Hans and Cronqvist, Mats and Nilsson, Ola},
  issn         = {0022-3085},
  language     = {eng},
  pages        = {58--63},
  publisher    = {American Association of Neurosurgeons},
  series       = {Journal of Neurosurgery},
  title        = {Nimodipine in aneurysmal subarachnoid hemorrhage: a randomized study of intravenous or peroral administration.},
  url          = {http://dx.doi.org/10.3171/2008.7.JNS08178},
  volume       = {110},
  year         = {2009},
}