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AJNR - American Journal of Neuroradiology

Published ahead of print on November 7, 2007
doi: 10.3174/ajnr.A0830

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Continuous Intra-Arterial Infusion of Nimodipine During Embolization of Cerebral Aneurysms Associated With Vasospasm

I. Oran^a and C. Cinar^a

^a From the Ege University Medical School Department of Radiology, Izmir, Turkey

View larger version (42K): [in this window] [in a new window]   Fig 1. Patient 10: an aneurysm of the left anterior choroidal artery. Angiogram obtained at anterior-posterior projection (A) shows a diffuse vasospasm involving the terminal internal carotid artery (ICA), the A1 and A2 segments of the anterior cerebral artery (ACA), and the M1 and M2 segments of the middle cerebral artery (MCA). Ten minutes later, after intra-arterial infusion of 1.5 mg of nimodipine, an angiogram at the same projection (B) shows slight improvement but still diffuse vasospasm. After the end of the embolization, under continuous nimodipine infusion at the dose of 1 mg per hour (total, 2 mg), an angiogram (C) shows significant vasorelaxation.

View larger version (47K): [in this window] [in a new window]   Fig 2. Patient 2: an aneurysm of the right posterior communicating artery. An angiogram obtained at the right anterior oblique projection (A) shows a vasospasm at the supraclinoid ICA, the A1 and A2 segments of the ACA, and the M1 and M2 segments of the MCA. Fourteen minutes later, after intra-arterial infusion of 2 mg of nimodipine, this angiogram (B) shows some degree of vasorelaxation, especially in the proximal segments of the ACA. Final angiogram at the same projection after completion of embolization (C), with continuous intra-arterial infusion of 1.5 mg of nimodipine throughout the procedure, demonstrates complete disappearance of the proximal vasospasm and near-complete clearance of the distal spasm as well as occlusion of the aneurysm.