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Classification of SAH
The severity of SAH and its effect on neurologic status varies considerably among patients. The Hunt and Hess scale is commonly used to estimate the surgical risk of the SAH patient.1 The Glasgow Outcome Scale sometimes is used to assess the outcomes of patients in Hunt and Hess Grades IV and V. Its five categories are good recovery, moderate disability (disabled but independent), severe disability (conscious but disabled), persistent vegetative state, and death.2
Hunt And Hess Scale For Grading SAH Grade Neurologic Status
- Asymptomatic; or minimal headache and slight nuchal rigidity
- Moderate to severe headache; nuchal rigidity; no neurologic deficit except cranial nerve palsy
- Drowsy, minimal neurologic deficit
- Stuporous; moderate to severe hemiparesis; possibly early decerebrare rigidity and vegetative disturbances
- Deep coma; decerebrate rigidity; moribund appearance
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Sources:
- Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg 1968:28:14-20.
- Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet 1975;1:480-484.
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DO NOT ADMINISTER NIMOTOP INTRAVENOUSLY OR BY OTHER PARENTERAL ROUTES. DEATHS AND SERIOUS, LIFE-THREATENING ADVERSE EVENTS HAVE OCCURRED WHEN THE CONTENTS OF NIMOTOP CAPSULES HAVE BEEN INJECTED PARENTERALLY
(See
WARNINGS and DOSAGE AND ADMINISTRATION.) |
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- In patients with SAH, Nimotop® controls damage with a low side effect profile.
- Decreased blood pressure is the most common side effect, occurring in 4.4% of patients. Blood pressure should be monitored during therapy.1
- Other side effects occurring at a low frequency of ≥1.0% include headache, nausea, and bradycardia.1
- No clinically significant effects on hematologic factors, renal or hepatic function, or carbohydrate metabolism have been causally associated with oral nimodipine.1
- Nimotop® does not appear to affect anesthetic management.2
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Sources:
- Nimotop® (nimodipine) Capsules Prescribing
Information December 2005
- Stullken EH, Johnston WE, Prough DS. Implications of nimodipine prophylaxis of cerebral vasospasm on anesthetic management during intracranial aneurysm clipping. J. Neurosurg. 1985; 62:200-205.
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© Bayer HealthCare Pharmaceuticals.
Bayer HealthCare Pharmaceuticals
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Wayne, NJ 07470
The information provided on Bayer products is only intended for the United States audience. Regulatory requirements, regulations, laws, and distribution of information about drug products may vary from country to country. Product names and indications (product uses) also may be different in different countries. The prescribing information provided here is based on United States labeling and may not be appropriate outside of the US.
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