Journal article
Combination of aminocaproic acid and nicardipine in treatment of aneurysmal subarachnoid hemorrhage
Stroke (1970), Vol.19(1), pp.63-67
1988
DOI: 10.1161/01.STR.19.1.63
PMID: 3336904
Abstract
Antifibrinolytic drugs reduce the risk of rebleeding during the first 2 weeks after aneurysmal subarachnoid hemorrhage. However, they do not lower overall mortality, largely because of an increased incidence of cerebral ischemia. The usefulness of antifibrinolytic drugs might be increased if a method to prevent or control vasospasm in patients were to be developed. We recently completed late Phase I and Phase II studies of the calcium ion blocking drug nicardipine in 67 patients treated within 1 week of subarachnoid hemorrhage. Of these 67 patients, 42 had delayed operations and were treated concomitantly with the antifibrinolytic drug aminocaproic acid (1.5 g/hr) for an average of 6 days before surgery. The outcome of these 42 patients is the subject of this report. Fifteen of 42 patients were treated with the lower dosage levels of nicardipine (0.4-4.5 mg/m2/hr), and 27 patients were treated at the highest dosage level (6.0 mg/m2/hr). Using the World Federation of Neurological Surgeons scale for subarachnoid hemorrhage, at admission 18 patients were Grade I, 15 were Grade II, 6 were Grade III, and 3 were Grade IV. Five patients (12%) developed clinical signs of deterioration suggestive of cerebral ischemia with concomitant evidence of vasospasm on arteriography. These patients were all treated with hypervolemic hypertensive therapy. Only one patient (2%) developed an infarction from vasospasm. Two patients developed symptomatic hydrocephalus requiring ventriculoperitoneal shunting, and a third patient required a temporary ventriculostomy. The 3-month postoperative outcomes were excellent. Three patients (7%) rebled. Three patients died, two from rebleeding of the aneurysm and one who never regained consciousness from the initial hemorrhage
Details
- Title: Subtitle
- Combination of aminocaproic acid and nicardipine in treatment of aneurysmal subarachnoid hemorrhage
- Creators
- David W Beck - Univ. Iowa hosp., div. neurosurgery, Iowa City IA 52242, United StatesHarold P Adams - Univ. Iowa hosp., div. neurosurgery, Iowa City IA 52242, United StatesEugene S Flamm - Univ. Iowa hosp., div. neurosurgery, Iowa City IA 52242, United StatesJohn C Godersky - Univ. Iowa hosp., div. neurosurgery, Iowa City IA 52242, United StatesChristopher M Loftus - Univ. Iowa hosp., div. neurosurgery, Iowa City IA 52242, United States
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.19(1), pp.63-67
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- DOI
- 10.1161/01.STR.19.1.63
- PMID
- 3336904
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 1988
- Academic Unit
- Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984020847702771
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