Continuous intra-arterial nimodipine infusion in refractory symptomatic vasospasm after subarachnoid hemorrhage
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Continuous intra-arterial nimodipine infusion in refractory symptomatic vasospasm after subarachnoid hemorrhage. / Helbok, Raimund; Zangerle, Alexandra; Chemelli, Andreas; Beer, Ronny; Benke, Thomas; Ehling, Rainer; Fischer, Marlene; Sojer, Martin; Pfausler, Bettina; Thome, Claudius; Schmutzhard, Erich.
in: SPRINGERPLUS, Jahrgang 5, Nr. 1, 2016, S. 1807.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Continuous intra-arterial nimodipine infusion in refractory symptomatic vasospasm after subarachnoid hemorrhage
AU - Helbok, Raimund
AU - Zangerle, Alexandra
AU - Chemelli, Andreas
AU - Beer, Ronny
AU - Benke, Thomas
AU - Ehling, Rainer
AU - Fischer, Marlene
AU - Sojer, Martin
AU - Pfausler, Bettina
AU - Thome, Claudius
AU - Schmutzhard, Erich
PY - 2016
Y1 - 2016
N2 - INTRODUCTION: Vasospasm still is a major cause of morbidity after aneurysmal subarachnoid hemorrhage. The purpose of this report is to describe the successful management of severe refractory vasospasm with continuous intra-arterial nimodipine (IAN) treatment.CASE DESCRIPTION: A 72-year old right handed woman was admitted with non-traumatic SAH WFNS grade 1. Cerebral computed tomography demonstrated thick blood filling of the basal cisterns, and intraventricular hemorrhage. Cerebral angiogram failed to detect a vascular abnormality. After an uneventful initial course the patient developed symptomatic left middle cerebral artery vasospasm with aphasia and corresponding restriction in diffusion weighted images in the left frontal lobe. Bolus IAN only transiently improved cerebral circulation and clinical signs and symptoms. Continuous-IAN was started and led to full clinical recovery and normalisation of MRI diffusion restrictions.DISCUSSION AND CONCLUSIONS: Continuous selective intra-arterial infusion of nimodipine may be an option in selected patients with symptomatic vasospasm refractory to conventional treatment after careful consideration of benefits and procedure-related risks.
AB - INTRODUCTION: Vasospasm still is a major cause of morbidity after aneurysmal subarachnoid hemorrhage. The purpose of this report is to describe the successful management of severe refractory vasospasm with continuous intra-arterial nimodipine (IAN) treatment.CASE DESCRIPTION: A 72-year old right handed woman was admitted with non-traumatic SAH WFNS grade 1. Cerebral computed tomography demonstrated thick blood filling of the basal cisterns, and intraventricular hemorrhage. Cerebral angiogram failed to detect a vascular abnormality. After an uneventful initial course the patient developed symptomatic left middle cerebral artery vasospasm with aphasia and corresponding restriction in diffusion weighted images in the left frontal lobe. Bolus IAN only transiently improved cerebral circulation and clinical signs and symptoms. Continuous-IAN was started and led to full clinical recovery and normalisation of MRI diffusion restrictions.DISCUSSION AND CONCLUSIONS: Continuous selective intra-arterial infusion of nimodipine may be an option in selected patients with symptomatic vasospasm refractory to conventional treatment after careful consideration of benefits and procedure-related risks.
U2 - 10.1186/s40064-016-3495-4
DO - 10.1186/s40064-016-3495-4
M3 - SCORING: Journal article
C2 - 27812447
VL - 5
SP - 1807
JO - SPRINGERPLUS
JF - SPRINGERPLUS
SN - 2193-1801
IS - 1
ER -