The Prognostic Significance of the Concentration of Nimodipine in the CSF and Plasma in Subarachnoid Hemorrhage

  • W. I. Steudel
  • M. Carvi
  • S. Tiyaworabun
  • R. Lorenz
Conference paper
Part of the Advances in Neurosurgery book series (NEURO, volume 18)


A major cause of mortality and morbidity in subarachnoid hemorrhage of aneurysmal origin is vasospasm. An analysis of the available placebo-controlled double-blind and open prospective studies provides statistically significant evidence that the calcium antagonist nimodipine can reduce the frequency of these spasm-induced delayed ischemic neurological deficits. However, very divergent percentages are reported in the various studies, ranging in the randomized studies from 1% with intravenous administration to 2%–16% with oral dosage [1–6,8–11]. It is unclear what intraindividual and interindividual variations in the plasma and CSF concentration are present or are to be expected in medication with nimodipine. A high level of protein binding and the interaction with other drugs are known with regard to pharmacokinetics [12].


Subarachnoid Haemorrhage Glasgow Outcome Scale Hydroxyethyl Starch Intraindividual Variation Early Aneurysm 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • W. I. Steudel
  • M. Carvi
  • S. Tiyaworabun
  • R. Lorenz
    • 1
  1. 1.Abteilung für Allgemeine NeurochirurgieJohann Wolfgang Goethe-UniversitätFrankfurt 71Germany

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