Evidence map›Paper›PMID 40383744›Full record

SynthesisNeurosurgical review2025

Efficacy and safety of intraventricular nimodipine in patients with aneurysmal subarachnoid hemorrhage compared to oral nimodipine: a systematic review and meta-analysis.

Hesham Kelani, Nancy Ibrahim, Ahmed Naeem, Hazem Mohamed Salamah, Nada Ashraf Al-Shafey, Yousef Tanas, Esraa Shawky Ibrahem, Fawzy Mohamed Fawzy Naga, Volodymyr Vulkanov, Mohamed Jadidi and 6 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Hesham KelaniNeurology Department, SUNY Downstate at One Brooklyn Health, Brooklyn, NY, USA.
Nancy IbrahimFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Ahmed NaeemAl-Azhar Faculty of Medicine, Asyut, Egypt.
Hazem Mohamed SalamahFaculty of Medicine, Zagazig University, Zagazig, Egypt.
Nada Ashraf Al-ShafeyFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Yousef TanasFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Esraa Shawky IbrahemFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Fawzy Mohamed Fawzy NagaFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Volodymyr VulkanovDepartment of Neurosurgery, Rutgers New Jersey School of Medicine, Newark, NJ, USA. vv263@njms.rutgers.edu.
Mohamed JadidiNeurology Department, SUNY Downstate at One Brooklyn Health, Brooklyn, NY, USA.
David P LernerNeurology Department, SUNY Downstate at One Brooklyn Health, Brooklyn, NY, USA.
Ketevan BerekashviliNeurology Department, SUNY Downstate at One Brooklyn Health, Brooklyn, NY, USA.
Moshe A MizrahiNeurology Department, SUNY Downstate at One Brooklyn Health, Brooklyn, NY, USA.
Alexander AndreevDepartment of Neurology, Zucker School of Medicine, Northwell health, Hempstead, NY, USA.
Diana Greene-ChandosDepartment of Neurology, School of Medicine, University of Saint Louis, Saint Louis, MO, USA.
Athos PatsalidesDepartment of Neurosurgery, North Shore University Hospital, Northwell, Manhasset, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high morbidity and mortality. Nimodipine is the only drug approved and administered orally as well as intravenously to improve the outcomes of patients with vasospasm post-SAH. EG-1962 is a sustained-release formulation of nimodipine administered into the subarachnoid space in patients with aSAH. We hypothesize that this may improve the efficacy of nimodipine and minimize its adverse effects. We searched PubMed, Cochrane, Scopus, and Web of Science on August 2, 2024, using relevant keywords. Studies were screened for eligibility. We extracted the data from the relevant articles and then these data were pooled as risk ratio (RR) and 95% confidence interval (CI), using R software. Pooled data from trials comparing intraventricular nimodipine with oral nimodipine showed a significantly lower risk of angiographic vasospasm in the intraventricular nimodipine cohort than the oral nimodipine cohort (RR = 0.8, CI [0.65-0.98]), and a trend towards lower risk of delayed cerebral ischemia and hypotension. No significant difference in extended Glasgow coma scale (eGCS) at 90 days of follow-up and other adverse events like hydrocephalus, bacterial meningitis, and serious adverse events including death. The risk of angiographic vasospasm was lower with intraventricular nimodipine compared with oral nimodipine, and there was a trend toward a decreased incidence of DCI and hypotension, which should be validated in future studies. However, there is no significant improvement in functional outcomes from intraventricular nimodipine. More rigorous research is needed to look at the underlying mechanisms and see if other factors influence the functional outcomes. Clinical trial number Not applicable.

Indexed as

NimodipineSubarachnoid HemorrhageVasodilator AgentsVasospasm, IntracranialAdministration, OralHumansInjections, IntraventricularTreatment OutcomeNimodipineVasodilator AgentsDelayed cerebral ischemiaMeta-analysisNimodipineSubarachnoid hemorrhageVasospasm

Identifiers

PMID40383744
PMCPMC12086118

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.