Nimodipine for subarachnoid haemorrhage: the end of the road or better trials?

摘要

Traumatic subarachnoid haemorrhage is a common finding in all degrees of severity of head injury and is an independent predictor of poor outcome. However, to what extent the presence of subarachnoid blood contributes to secondary deterioration or whether this is simply an epiphenomenon of the injury is unclear. In patients with aneurysmal subarachnoid haemorrhage nimodipine is widely used for the prevention and treatment of cerebral vasospasm, a major contributorto morbidity and mortality in this disorder. Although the main effect of nimodipine; is thought to be relaxation of the smooth muscle of the cerebral vasculature mediated by its Ca2+antagonistic action, other mechanisms have been invoked, including possible antioxidant activity.