Evidence map›Paper›PMID 41186788›Full record

Observational studyActa neurochirurgica2025

Continuous intracisternal nimodipine administration as rescue therapy for refractory vasospasm in patients with aneurysmal subarachnoid haemorrhage.

Mandy D Müller, Katharina Janosovits, David Bervini, Pasquale Mordasini, Tomas Dobrocky, Eike I Piechowiak, Joerg C Schefold, Michael Murek, Johannes Goldberg, Philippe Schucht and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Mandy D MüllerDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Katharina JanosovitsDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
David BerviniDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Pasquale MordasiniInstitute of Diagnostic and Interventional Neuroradiologiy, Center for Imaging and minimally invasive Therapies, Kantonsspital Aarau (KSA), Aarau, Switzerland.
Tomas DobrockyDepartment of Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Eike I PiechowiakDepartment of Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Joerg C SchefoldDepartment of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Michael MurekDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Johannes GoldbergDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Philippe SchuchtDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Andreas RaabeDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Werner J Z'GraggenDepartment of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. werner.zgraggen@faculty.unibe.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDelayed cerebral ischaemia (DCI) and cerebral vasospasm (CVS) remain major causes of poor outcome in survivors of aneurysmal subarachnoid haemorrhage (aSAH). We aimed to investigate the safety and efficacy of intracisternal administration of nimodipine in patients suffering from symptomatic CVS refractory to treatment with induced hypertension and endovascular vasodilator therapy.

methodsWe performed a single-centre, retrospective, observational study including all patients diagnosed with refractory CVS after aSAH treated at our tertiary centre between January 2018 and December 2021 who received continuous intracisternal nimodipine. For nimodipine administration, a catheter was inserted in the optico-carotid cistern via supraorbital craniotomy. Our primary outcome was functional independence measured by the modified Rankin Scale (mRS) at 6 months. Secondary outcomes included treatment related complications and neurological outcome.

resultsWe included 15 patients in total. Clinical outcome measured by the mRS at 6 months was good with 93.3% of patients showing mRS ≤ 1 (median mRS 1; range 1-4) Eight patients (53%) developed a new CVS-related neurological deficit during intrathecal nimodipine treatment and additionally received bolus intra-arterial nimodipine. Two patients (13%) developed acute subdural/epidural hematoma postoperatively, which was treated surgically in one patient. In two patients (13%), accidental dislocation of the intrathecal catheter occurred, which warranted re-operation.

conclusionContinuous intracisternal administration of nimodipine may be a viable rescue therapy option for patients with refractory CVS but is associated with an increased risk of treatment related complications.

Indexed as

NimodipineSubarachnoid HemorrhageVasodilator AgentsVasospasm, IntracranialAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeNimodipineVasodilator AgentsCerebral infarctionCerebral perfusionCerebral vasospasmDelayed cerebral ischaemiaFunctional outcome

Identifiers

PMID41186788
PMCPMC12586204

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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.