• E A Popovic, R A Danks, and K H Siu.
• Monash Medical Centre, Prince Henry's Hospital Campus, Melbourne, Vic.
• Med. J. Aust. 1993 Jan 18; 158 (2): 91-4.

ObjectivesTo assess the efficacy of nimodipine in preventing delayed ischaemic deficit in aneurysmal subarachnoid haemorrhage.DesignA continuous prospective audit of all patients with aneurysmal subarachnoid haemorrhage admitted to the joint neurosurgery units of Prince Henry's and Alfred hospitals, Melbourne. Patients were divided into two groups--135 in the pre-nimodipine group during 1986 to 1989, and 73 in the nimodipine group during 1989 and 1990.Main Outcome MeasuresOutcome was measured according to the Glasgow outcome scale and the incidence of delayed ischaemic deficit was recorded.ResultsA substantial reduction in the overall incidence of poor outcome was observed, from 37% of patients in the non-nimodipine group, to 20% in the nimodipine group (P = 0.022). Delayed ischaemic deficit occurred in 41% and 21% (P = 0.005), and poor outcome due to delayed ischaemic deficit occurred in 18% and 8% (P = 0.09) respectively.ConclusionsIn our experience, nimodipine appears to have substantially reduced the incidence of delayed ischaemic deficits in patients with aneurysmal subarachnoid haemorrhage, with a resultant improvement in overall patient outcome.

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