Effect of Cisternal Administration of Nicardipine Hydrochloride on Cerebral Vasospasm: A Preliminary Report

In six subarachnoid hemorrhage (SAH) cases due to aneurysmal rupture, effects of cisternal administration of Nicardipine hydrochloride (nicardipine) on vasospasm wer studied. Nicardipine is one of calcium antagonists. All aneurysms were clipped within 48 hr after the onset of SAH with ventricular and cisternal drainages. Subarachnoid clot was removed as much as possible. Nicardipine or mixture of nicardipine and urokinase was administered through cisternal drainage once a day for 10 days postoperatively. The dose of nicardipine was 2 mg or 4 mg, and that of urokinase was 6,000 units or 24,000 units. On the 7th day after the onset of SAH, angiograms were performed before and 30 min after the cisternal administration of nicardipine. Then the diameters of each arteries were compared in order to estimate the vasodilative effects of nicardipine angiographically. In this study nicardipine was considered to have some prophylactic effect on vasospasm because vasospasm was not observed either angiographically or clinically in 2 out of 3 severe SAH cases on CT.