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AJNR - American Journal of Neuroradiology

Published ahead of print on March 27, 2008
doi: 10.3174/ajnr.A1005

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Intra-Arterial Nimodipine for Severe Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Influence on Clinical Course and Cerebral Perfusion

D. Hänggi^a, B. Turowski^b, K. Beseoglu^a, M. Yong^c and H.J. Steiger^a

^a Departments of Neurosurgery, Heinrich-Heine-University, Düsseldorf, Germany
^b Neuroradiology, Heinrich-Heine-University, Düsseldorf, Germany
^c Institute of Statistics in Medicine, Heinrich-Heine-University, Düsseldorf, Germany

View larger version (27K): [in this window] [in a new window]   Fig 1. The box-plot profiles of blood-flow velocity measured with TCD, from day 0 (preintervention) to the 7 days postintervention. The plus represents the sample mean value. The asterisk indicates P < .05 for the change from baseline.

View larger version (15K): [in this window] [in a new window]   Fig 2. The box-plot profiles of perfusion parameters measured with perfusion CT: MTT (A), Tmax (B), cerebral blood flow (C), and cerebral blood volume (D), by time 0 (preintervention), 1 (first day after intervention), 2 (2–5 days postintervention), to 3 (5–9 days postintervention). The plus signs are the sample mean values. The asterisk indicates P < .05 for the change from baseline.

View larger version (17K): [in this window] [in a new window]   Fig 3. Correlation between the first day change of flow velocity measured with TCD and the first day change of perfusion parameters measured with perfusion CT: MTT (A), Tmax (B), cerebral blood flow (C), and cerebral blood volume (D). Data are presented with correlation coefficients (r) and univariate linear regression with 95% confidence intervals.

View larger version (93K): [in this window] [in a new window]   Fig 4. Illustrative case 12. A, Baseline angiogram on day 6 documents severe vasospasm in the left M1 and M2 segments (arrows). B, DSA obtained 10 minutes after the injection of 1.6-mg nimodipine reveals reduction of the vasospasm (arrows). C, PCT approximately 24 hours after IAN demonstrates a reduction of MTT and Tmax. D, No ischemic lesions are documented on the CT scan obtained at the time of discharge.