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Clinical Manifestations
SAH is a medical emergency requiring the immediate application of appropriate diagnostic and therapeutic measures. The characteristic symptom of SAH is sudden headache that is unusual to the patient in terms of its severity and nature; it may be accompanied by a brief loss of consciousness, nausea and/or vomiting, focal neurologic deficits, and development of a painful stiff neck over several hours.1,2 However, SAH may occur in the absence of these latter symptoms.3 A sudden headache that steadily abates may reflect a mild episode of bleeding; if recognized, this "leak" could serve as a warning of future aneurysmal rupture. However, in a study of 148 patients with sudden and severe headache, Linn er al. found no support for the notion of warning leaks.4
Sources:
- Mayberg MR, Batjer HH, Dacey R et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Hearth Association. Stroke 1994;25:2315-2328.
- Findlay JM. Current management of aneurysmal subarachnoid hemorrhage guidelines from the Canadian Neurosurgial Society. Can J Neurol Sci 1997; 24:161-170.
- Vermeulen M. Subarachnoid haemorrhage: diagnosis and treatment. J Neurol 1996;243:496-501.
- Linn FHH, Wijdicks EFM, van der Graaf Y, Weerdesteyn-van Vliet FAC, Bartelds AIM, van Gijn J. Prospective study of sentinel headache in aneurysmal subarachnoid haemorrhage. Lancet 1994; 344:590-593.
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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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