Intra-arterial injection of verapamil in treatment of cerebral vasospasm in a patient with acute subarachnoid hemorrhage from an aneurysm: case report

Mikeladze K.G.; Éliava Sh.Sh.; Shekhtman O.D.; Lubnin A.Yu.; Tabasaranskiĭ T.F.; Yakovlev S.B.

doi:https://doi.org/

Mikeladze K.G.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Shekhtman O.D.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Lubnin A.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia, N.N. Burdenko Research Institute of Neurosurgery, Moscow, Russia, Department of Obstetrics and Gynecology, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia

RSCI AuthorID: 370609
Scopus AuthorID: 57192157123
ORCID: 0000-0003-2595-5877

Tabasaranskiĭ T.F.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

ORCID: 0000-0002-0798-2604

Intra-arterial injection of verapamil in treatment of cerebral vasospasm in a patient with acute subarachnoid hemorrhage from an aneurysm: case report

Authors:

Mikeladze K.G., Éliava Sh.Sh., Shekhtman O.D., Lubnin A.Yu., Tabasaranskiĭ T.F., Yakovlev S.B.

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Journal: Burdenko's Journal of Neurosurgery. 2013;77(4): 57‑60

Read: 4516 times

To cite this article:

Mikeladze KG, Éliava ShSh, Shekhtman OD, Lubnin AYu, Tabasaranskiĭ TF, Yakovlev SB. Intra-arterial injection of verapamil in treatment of cerebral vasospasm in a patient with acute subarachnoid hemorrhage from an aneurysm: case report. Burdenko's Journal of Neurosurgery. 2013;77(4):57‑60. (In Russ., In Engl.)

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)

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Abstract:

Cerebral vasospasm is a major cause of cerebral ischemia and neurological deficits in patients after SAH from the aneurysm. According to angiorraphy cerebral vasospasm in acute rupture of an aneurysm is detected in 50-70% of cases, and the risk of ischemia on it's background is 19-46%. One of the new trends of treatment of cerebral vasospasm is the intra-arterial injection of calcium channel blockers. The article presents a case of selective intra-arterial injection of verapamil for the treatment of cerebral vasospasm in patient after severe subarachnoid and parenchymal hemorrhage of the internal carotid artery bifurcation aneurysm with a good clinical outcome.

Keywords:

cerebral vasospasm

intra-arterial verapamil injection

Authors:

Mikeladze K.G.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

Éliava Sh.Sh.

NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva

Shekhtman O.D.

FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva

Lubnin A.Yu.

RSCI AuthorID: 370609
Scopus AuthorID: 57192157123
ORCID: 0000-0003-2595-5877

Tabasaranskiĭ T.F.

FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva

Yakovlev S.B.

Burdenko’ National medical research center of neurosurgery, Moscow, Russia

ORCID: 0000-0002-0798-2604

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References:

Babbitt D.G., Perry J.M., Forman M.B. Intracoronary verapamil for reversal of refractory coronary vasospasm during percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1988; 12: 1377—1381.
Biondi A., Ricciardi G.K., Puybasset L. et al. Intra-arterial nimodipine for the treatment of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage: preliminary results. AJNR 2004; 25: 1067—1076.
Jun P., Ko N.U., English J.D. et al. Endovascular treatment of medically refractory cerebral vasospasm following aneurysmal subarachnoid hemorrhage. AJNR 2010; 31: 1911—1916.
Karinen P., Koivukangas P., Ohinmaa A. et al. Cost effectiveness analysis of nimodipine treatment after aneurysmal subarachnoid hemorrhage and surgery. Neurosurgery 1999; 45: 780—784; discussion 784—785.
Keuskamp J., Murali R., Chao K.H. High-dose intraarterial verapamil in the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg 2008; 108: 458—463.
Keyrouz S.G., Diringer M.N. Clinical review: Prevention and therapy of vasospasm in subarachnoid hemorrhage. Crit Care 2007; 11: 220.
Komotar R.J., Zacharia B.E., Otten M.L. et al. Controversies in the endovascular management of cerebral vasospasm after intracranial aneurysm rupture and future directions for therapeutic approaches. Neurosurgery 2008; 62: 897—905; discussion 905—907.
Sehy J.V., Holloway W.E., Lin S.P. et al. Improvement in angiographic cerebral vasospasm after intra-arterial verapamil administration. Am J Neuroradiol 2010; 31: 1923—1928.
Shand D.G., Hammill S.C., Aanonsen L., Pritchett E.L. Reduced verapamil clearance during long-term oral administration. Clin Pharmacol Ther 1981; 30: 701—706.
Stiefel M.F., Heuer G.G., Abrahams J.M. et al. The effect of nimodipine on cerebral oxygenation in patients with poor-grade subarachnoid hemorrhage. J Neurosurg 2004; 101: 594—599.
Stiefel M.F., Spiotta A.M., Udoetuk J.D. et al. Intra-arterial papaverine used to treat cerebral vasospasm reduces brain oxygen. Neurocrit Care 2006; 4: 113—118.
Stuart R.M., Helbok R., Kurtz P. et al. High-dose intra-arterial verapamil for the treatment of cerebral vasospasm after subarachnoid hemorrhage: Prolonged effects on hemodynamic parameters and brain metabolism. Neurosurgery 2011; 68: 337—345.