Which of the following drug is used for reversal of cerebral vasospasm and infarct following subarachnoid hemorrhage? (AI 2012)
· Nimodipine is a cerebroselective calcium channel blocker that can reduce mortality after subarachnoid hemorrhage. It is indicated in the patients who had a hemorrhagic stoke.
· Nicardipine also have similar effects and can be used by intravenous as well as intra-cerebral arterial infusion to prevent cerebral vasospasm associated with stroke.
· The term" cerebral vasospasm" is commonly used to refer to the clinical picture of delayed onset of ischemic neurological deficits associated with aneurysmal SAH. Arterial vasospasm typically appears 3 to 4 days after rupture and reaches a peak in incidence and severity at 7-10 days. Symptoms typically begin 4-5 days after the hemorrhage and are characterized by the insidious onset of confusion and a decreasing level of consciousness.
The main goal of current treatment plan of cerebral vasospasm is to prevent or limit the severity of arterial and symptomatic vasospasm. Only two treatments are generally accepted to be of substantial value in reducing the ischemic complications related to vasospasm:
1) Treatment with cerebroselective calcium channel blocker nimodipine.
2) Hypervolemic, hypertensive therapy is used to elevate the cerebral perfusion pressure and thus provide blood to regions of the brain with marginal perfusion because of arterial spasm.