Background: nimodipine is the most widely preferred and administered calcium channel blocker in cerebral vasospasm prevention and treatment. There is no experimental or clinical study investigating the comparative effects of routine treatment modalities.
Method: 35 male New Zealand White rabbits were assigned randomly to one of seven groups: Control, only SAH, SAH/oral nimodipine, SAH/IV nimodipine, SAH/IT nimodipine, SAH/IA nimodipine, SAH/angiography.
Findings: basilar artery vessel diameters are measured by angiography. Basilar artery vessel diameters and luminal sectional areas are measured in pathology slides. Basilar artery thicknesses were significantly higher in group 2 and 7 than the others (p < 0.05). Luminal sectional areas in group 5 and 6 were significantly higher than other groups (p < 0.05). We found no significant difference in group 1, 5 and 6 (p > 0.05). Basilar section areas in group 3 and 4 were significantly higher than group 2 but lower than group 1.
Conclusion: this is the first study to show the most effective drug delivery route in CVS after SAH. Nimodipine treatment in cerebral vasospasm is useful. This study showed that selective IA nimodipine treatment and IT nimodipine treatment must be preferred to IV and oral treatments of chronic vasospasm following SAH.
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http://dx.doi.org/10.1007/978-3-7091-0356-2_5 | DOI Listing |
Ann Indian Acad Neurol
January 2025
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Background And Objectives: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of stroke characterized by headache, seizures, focal deficits, or encephalopathy. Very little is known about this rare condition from the Indian subcontinent. Here, we present the clinical and imaging characteristics and short-term outcomes of RCVS patients from South India.
View Article and Find Full Text PDFSurg Neurol Int
December 2024
Department of Neurosurgery, Christ the Redeemer Hospital, Porto Alegre, Rio Grande do Sul, Brazil.
Background: This study aimed to analyze the incidence of delayed cerebral ischemia (DCI) and outcome stratified by age in patients who suffered aneurysmal subarachnoid hemorrhage.
Methods: A cohort study with patients from Christ the Redeemer Hospital from 2014 to 2020, with 359 patients separated into 2 groups, 48 of them aged under 40 years and 311 aged 40 years or over.
Results: In patients under 40 years of age, DCI was found in 81.
Medicina (Kaunas)
December 2024
Experimental Animals Application and Research Center, Duzce University, Duzce 81100, Türkiye.
: Subarachnoid hemorrhage (SAH) is a life-threatening cerebrovascular condition that triggers a robust inflammatory response and cerebral vasospasm. This study aimed to evaluate the effects of anakinra, an interleukin-1 receptor antagonist, and tocilizumab, an interleukin-6 receptor antagonist, on inflammation and vasospasm in an experimental rat SAH model. : Forty male Sprague Dawley rats (200-250 g) were randomly assigned to five groups: control, SAH, SAH + anakinra (ANA), SAH + tocilizumab (TCZ), and SAH + anakinra + tocilizumab (ANA+TCZ).
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Neurology and Neurintensive Care Medicine, Academic Hospital Darmstadt, 64283 Darmstadt, Germany.
The clinical course of patients with aneurysmal SAH (aSAH) is often dynamic and highly unpredictable. Since its management varies between hospitals despite guidelines, this survey aimed to assess the current state of intensive care treatment for aSAH in the German-speaking region and provide insights that could aid standardization of care for aSAH patients in the intensive care setting. From February 2023 to April 2023, medical professionals of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), the Initiative of German Neuro-Intensive Trial Engagement (IGNITE) network and manually recorded clinics with intensive care units were invited to participate in a standardized anonymous online questionnaire including 44 questions.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Aneurysmal Subarachnoid Hemorrhage (aSAH), resulting from ruptured aneurysms, is a major contributor to stroke-related mortality and morbidity. Despite advances in healthcare, aSAH remains severe and often leads to complications such as cerebral vasospasm (CV), cerebral infarction, and delayed ischemic neurological deficits (DIND). Clazosentan, an endothelin receptor antagonist, has demonstrated potential in alleviating vasospasm and its associated outcomes, although evidence of its efficacy remains unclear.
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