The efficacy of intravenous Nimodipine (used at the rate of 2 mg.h-1) was investigated in the treatment of delayed ischemic deterioration or angiographic vasospasm after subarachnoid haemorrhage caused by a ruptured aneurysm in a randomized, double-blind, placebo-controlled multicenter study. A total of 127 case reports was validated: 73 patients received Nimodipine, 54 received placebo. The two groups were comparable in demographic and clinical status data. Analysis of number of deaths and of patients with severe deficit related to vasospasm alone showed a significant statistical difference (Nimodipine = 19%; Placebo = 49%; p = 0.01). The risk of mortality connected with vasospasm was reduced by 82% in the treated group. Side effects were equally frequent in the two groups. The only difference noted was the increase in heart rate in group Nimodipine. The results of this study demonstrate the efficacy of intravenous Nimodipine in the treatment of consequences of cerebral vasospasm after a subarachnoid haemorrhage caused by a ruptured aneurysm.
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J Neuroimaging
January 2025
Department of Neurology, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Background And Purpose: While the pulsatility index (PI) measured by transcranial Doppler (TCD) has broader associations with outcomes in neurocritical care, its use in monitoring delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid hemorrhage (SAH) is not endorsed by current clinical guidelines. Recognizing that arterial pressure gradient (ΔP) can be estimated using PI, we investigated the potential significance of TCD-estimated ΔP.
Methods: In this observational study of 186 SAH patients, we recorded the mean cerebral blood flow velocity (mCBFV) and PI values from the middle cerebral artery, along with corresponding blood pressures.
Med Klin Intensivmed Notfmed
January 2025
Paracelsus Medizinische Privatuniversität, Institut für Pflegewissenschaft und -praxis, Salzburg, Österreich.
Background: Early mobilization of critical ill patients in the intensive care unit (ICU) has a positive effect on outcome. Currently, due to concerns of cerebral vasospasm and rebleeding patients with subarachnoid hemorrhage (SAH) have a prolong bedrest for 12-14 days.
Objective: What effect does early mobilization have on vasospasm, clinical outcome, length of stay and ICU complication rate in patients with SAH compared to standard treatment?
Methods: A systematic literature search was conducted in MEDLINE via the PubMed® (U.
Elife
January 2025
Department of Neurosurgery, Washington University School of Medicine, Springfield, United States.
Background: Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia. Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients. However, the effects of taVNS on cardiovascular dynamics in critically ill patients, like those with SAH, have not yet been investigated.
View Article and Find Full Text PDFAnn 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.
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