Data in 25 patients treated with intra-arterial nimodipine for symptomatic cerebral vasospasm after SAH
Pt/No. of Tx | Indication for Angiography | Days after SAH | Symptom Onset after Spasm, h | Vessel with Spasm | Side | Spasm Severity | Vessel Infused | Nimodipine Dose per Session, mg | SAP Change, mm Hg | Angio-graphic Results | Clinical Results | GOS Score | Modified Rankin Score |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1/1 | Decreased LOC | 6 | 18 | tICA, MCA | R | Moderate | ICA R | 1.0 | 0 | Good | Improved | 2 | 2 |
2/1 | Decreased LOC | 7 | 18 | tICA, MCA, ACA | L | Severe | ICA L | 1.0 | −10 | Excellent | Improved | 1 | 1 |
3/1 | Decreased LOC | 6 | 24 | tICA, MCA, ACA | R/L | Moderate | ICA R/L | 3.0 | −15 | Poor | Unchanged | 3 | 3 |
4/1 | R hemiparesis | 7 | 18 | tICA, MCA, ACA | L | Moderate | ICA L | 2.0 | −10 | Poor | Improved | 1 | 0 |
5/1 | L hemiparesis | 8 | 24 | ACA | R | Mild | ICA R | 1.0 | 0 | Good | Improved | 2 | 2 |
6/2 | L MCA > 200 cm/s | 7 | 6 | tICA, MCA, ACA | L | Severe | ICA L | 2.0 | −20 | Poor | Unchanged | ||
6* | R hemiparesis | 9 | 24 | tICA, MCA, ACA | L | Severe | ICA L | 3.0 | −20 | Good | Unchanged* | 3 | 3 |
7/1 | Dysphasia | 10 | 12 | MCA | L | Mild | ICA L | 3.0 | −15 | Poor | Improved | 1 | 0 |
8/1 | Disorientation | 9 | 24 | tICA, MCA, ACA | L | Severe | ICA L | 2.0 | −20 | Poor | Improved | 1 | 0 |
9/1 | Decreased LOC | 5 | 18 | tICA, MCA | L | Moderate | ICA L | 1.0 | 10 | Good | Improved | 3 | 3 |
10/1 | R-leg monoparesis | 15 | 18 | ACA | L | Mild | ICA L | 2.0 | −15 | Good | Improved | 1 | 0 |
11/1 | Decreased LOC | 6 | 24 | tICA, ACA | R | Moderate | ICA R | 2.0 | −30 | Good | Improved | 2 | 2 |
12/2 | L hemiparesis | 7 | 12 | Diffuse | R/L | Severe | ICA R/L, VA L | 3.0 | −20 | Poor | Unchanged | ||
12* | L hemiparesis | 8 | 24 | Diffuse | R/L | Severe | ICA R/L, VA L | 5.0 | −30 | Good | Improved* | 5 | 6 |
13/1 | Decreased LOC | 4 | 12 | tICA, MCA, ACA | R/L | Moderate | ICA R/L | 3.0 | −30 | Poor | Unchanged | 5 | 6 |
14/2 | Cranial nerve III paresis | 11 | 18 | BA, PCA | R | Moderate | VA L | 3.0 | −20 | Poor | Unchanged | ||
14* | Cranial nerve III paresis | 12 | 24 | BA, PCA | R | Moderate | VA L | 2.0 | −25 | Poor | Improved* | 1 | 0 |
15/1 | Dysphasia, temp >38°C | 7 | 12 | MCA, ACA | R/L | Moderate | ICA R/L | 2.0 | −10 | Poor | Unchanged | 2 | 2 |
16/1 | Decreased LOC, disorientation | 5 | 12 | Diffuse | R/L | Severe | ICA R/L, VA | 3.0 | −20 | Good | Improved | 2 | 2 |
17/1 | Decreased LOC disorientation | 10 | 24 | tICA, MCA, ACA | R | Moderate | ICA R | 2.0 | 0 | Good | Improved | 1 | 1 |
18/1 | R/L MCA > 190 cm/s | 11 | 18 | tICA, MCA, ACA | L | Moderate | ICA L | 2.0 | −20 | Poor | Unchanged | 3 | 3 |
19/1 | Decreased LOC | 10 | 24 | Diffuse | R/L | Severe | ICA R/L VA | 5.0 | −35 | Excellent | Improved | 2 | 2 |
20/3 | Decreased LOC | 4 | 12 | tICA, MCA, ACA | L | Moderate | ICA L | 2.0 | −30 | Poor | Unchanged | ||
20* | Decreased LOC, L MCA > 140 cm/s | 5 | 24 | tICA, MCA, ACA | L | Moderate | ICA L | 3.0 | −25 | Poor | Unchanged* | ||
20† | Decreased LOC, L MCA > 160 cm/s | 6 | 48 | tICA, MCA, ACA | L | Severe | ICA L | 3.0 | −40 | Poor | Improved† | 1 | 0 |
21/1 | L hemiparesis | 8 | 24 | tICA, MCA | R | Moderate | ICA R | 3.0 | −10 | Poor | Improved | 2 | 2 |
22/1 | Decreased LOC | 5 | 12 | ACA | R | Severe | ICA R | 3.0 | −15 | Good | Improved | 2 | 2 |
23/1 | Decreased LOC | 6 | 6 | tICA, ACA | R | Moderate | ICA R | 3.0 | −25 | Poor | Improved | 1 | 0 |
24/1 | Decreased LOC | 10 | 24 | tICA, ACA | L | Moderate | ICA L | 2.0 | −30 | Poor | Unchanged | 3 | 3 |
25/1 | Decreased LOC | 5 | 12 | tICA, MCA, ACA | L | Severe | ICA L | 3.0 | −20 | Good | Improved | 2 | 2 |
Note.—ACA indicates anterior cerebral artery; BA, basilar artery; GOS, Glasgow Outcome Scale (5 indicates death); ICA, internal carotid artery; LOC, level of consciousness; PCA, posterior cerebral artery; SAP, systolic artery pressure; Tx, treatment; and VA, vertebral artery.
* Second treatment.
† Third treatment.