gms | German Medical Science

60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Dose-related efficacy of a continuous intracisternal nimodipine treatment on cerebral vasospasm in the rat double subarachnoid haemorrhage model

Meeting Abstract

  • D. Hänggi - Neurochirurgische Klinik, Klinikum der Heinrich-Heine-Universität Düsseldorf
  • S. Eicker - Neurochirurgische Klinik, Klinikum der Heinrich-Heine-Universität Düsseldorf
  • K. Beseoglu - Neurochirurgische Klinik, Klinikum der Heinrich-Heine-Universität Düsseldorf
  • M. Rapp - Neurochirurgische Klinik, Klinikum der Heinrich-Heine-Universität Düsseldorf
  • J. Perrin - Neurochirurgische Klinik, Klinikum der Heinrich-Heine-Universität Düsseldorf
  • H.-J. Steiger - Neurochirurgische Klinik, Klinikum der Heinrich-Heine-Universität Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.03-04

DOI: 10.3205/09dgnc121, URN: urn:nbn:de:0183-09dgnc1216

Veröffentlicht: 20. Mai 2009

© 2009 Hänggi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Intracisternal continuous therapy is a concept in the treatment of cerebral vasospasm after subarachnoid haemorrhage (SAH). The purpose of the current study was to investigate the effect of intracisternal nimodipine after induced vasospasm.

Methods: 65 male Wistar rats were randomized into four groups; the control sham operated group, the control SAH only group and the treatment groups receiving 5 µl/h or 10 µl/h intracisternal nimodipine continuously for 5 days via subcutaneously implanted ALZET® osmotic pumps. Vasospasm was analyzed 5 days later by means of digital subtraction angiography (DSA). Morphological examination of the brain parenchyma was performed using Nissl-staining, c-Fos immunohistochemistry and TUNEL staining.

Results: Detailed analysis of the DSA was possible for 31 animals. Significant angiographic vasospasm was induced with the double haemorrhage only group compared to the sham operated group (p=0.002). Between the four groups there were statistically significant differences of the arterial vessel caliber as measured by DSA (p=0.001, Kruskal-Wallis test). The treatment group receiving 5µl/h of nimodipine and the control sham operated group demonstrated the largest intracranial artery diameters with a significant difference between control SAH only group and the treatment group receiving 10µl/h of nimodipine (p=0.0328, Wilcoxon rank-sum-test). In all SAH groups, a few scattered TUNEL positive cells were detectable.

Conclusions: Intracisternal nimodipine lavage with 5µl/h, but not with 10µl/h leads to significant arterial relaxation. Further research is necessary to elucidate the underlying cause of decreasing nimodipine effect at higher dosage.