The German Study of Nimodipine in Traumatic Subrachnoid Haemorrhage

Abstract

With the excellent co-operation of 21 centres (Table 21) in Germany, a randomized, double-blind, placebo-controlled trial in traumatic subarachnoid haemorrhage (TSAH) was performed. The rationale for this trial was the frequent occurrence of TSAH in head injury (Table 22). In the HIT-II trial in Europe, one third of the patients had a TSAH on the first CT scan. The Americans reported an in-cidence of 40% of TSAH in their traumatic coma data bank. HIT-II also showed that TSAH worsened the outcome in head-injured pa-tients. Sixty % of patients with a TSAH had an unfavourable out-come, compared with 30% when there was no such finding on CT scan. At that time it was speculated that the pathophysiology of TSAH was similar to that of aneurysmal SAH, and we saw that TSAH patients had a better outcome after nimodipine. The aim of the study was to describe TSAH as a clinical entity, to study the effect of nimodipine on the outcome and on vasospasm, and to confirm the results of HIT-II on the effect of nimodipine on TSAH.