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Journal of Korean Neurosurgical Society 1986;15(2): 237-244.
Clinical Trial of Nimodipine in Patients with Aneurysmal Subarachnoid Hemorrhage.
Kyu Sung Lee, Kyu Chang Lee
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
Forty-three patients with aneurysmal subarachnoid hemorrhage entered and thirth-three of them completed the Nimodipine trial at the Yonsei University Hospital, under the Study Protocol provided by the Bayer AG, to determine the efficacy of preventing vasospasm as well as to evaluate the tolerability of this calcium channel blocker. Treatment was started within four days of initial bleeding and continued for two weeks. Fixed neurological deficits developed in seven of the 33 patients - four from vasospasm, two from raised intracranial pressure, and one from rebleeding. The incidence of symptomatic vasospasm in the patients treated with Nimodipine was 12.1%, which accounts for about one third of the rate experienced before the Nimodipine treatment at our hospital during the past five years(33.2%). Twenty-five patients were operated on without surgical mortality, and the morbidity rate was 8%. Management outcome became worse in proportion to increasing amount of blood in the basal cistern on initial CT scan. Side effects from the Nimodipine treatment was reversible and insignificant. These results suggest that the calcium antagonist administered to the patients with aneurysmal subarachnoid hemorrhage may reduce the incidence of delayed ischemic deficits.
Key Words: Cerebral aneurysm; Subarachnoid hemorrhage; Vasospasm; Calcium channel; Calcium channel blocker; Nimodipine
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