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首页> 外文期刊>Pediatric neurology >Nimodipine for the Prevention of Cerebral Vasospasm After Subarachnoid Hemorrhage in 12 Children
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Nimodipine for the Prevention of Cerebral Vasospasm After Subarachnoid Hemorrhage in 12 Children

机译：尼莫地平预防蛛网膜下腔出血后脑血管痉挛12例

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INTRODUCTION: Subarachnoid hemorrhage is a rare, but life-threatening neurological emergency. Cerebral vasospasm is a complication of subarachnoid hemorrhage that contributes significantly to morbidity and mortality. Nimodipine has been used in adults to reduce the incidence of cerebral vasospasm after subarachnoid hemorrhage and improve long-term outcomes. There are, however, no data in children. METHODS: Records of children with a confirmed diagnosis of subarachnoid hemorrhage who received nimodipine between January 1, 2005 and August 31, 2013 were reviewed. Dosing of nimodipine and associated hypotensive events were recorded. Transcranial Doppler ultrasonography, cranial computerized tomography, and angiography were followed as a measure of cerebral vasospasm, rebleeding, and subsequent infarction. RESULTS: Twelve children (average age 11.8 +/- 3.3 years, age range 3.5 to 17.3 years) were included. Aneurysm was responsible for the highest percentage (41.7%) of subarachnoid hemorrhage events. The mean dose of oral nimodipine was 1 mg/kg every 4 hours and was associated with a high rate of hypotension requiring intervention or dose modification. Clinical outcomes while on nimodipine therapy varied; evidence of vasospasm was observed in 67%, new infarction in 33%, and rebleeding in 17%. Functional and cognitive deficits were minor in two-thirds and absent in the remaining individuals. All patients survived until hospital discharge. CONCLUSIONS: Oral nimodipine after subarachnoid hemorrhage in children does not eliminate vasospasm, rebleeding, or infarction and is associated with significant hypotension. Nevertheless, clinical outcomes appear favorable relative to the adult population who receive nimodipine. Further study, with dose titration, is warranted.
机译：简介：蛛网膜下腔出血是一种罕见的但危及生命的神经系统紧急情况。脑血管痉挛是蛛网膜下腔出血的一种并发症，对发病率和死亡率有重大贡献。尼莫地平已用于成人，以减少蛛网膜下腔出血后脑血管痉挛的发生率并改善长期预后。但是，没有儿童的数据。方法：回顾性分析了2005年1月1日至2013年8月31日接受尼莫地平治疗的确诊为蛛网膜下腔出血的儿童的记录。记录了尼莫地平的剂量和相关的降压事件。随后进行经颅多普勒超声检查，颅脑计算机断层扫描和血管造影，以测量脑血管痉挛，再出血和随后的梗塞。结果：包括十二名儿童（平均年龄11.8 +/- 3.3岁，年龄范围3.5到17.3岁）。动脉瘤是蛛网膜下腔出血事件的最高百分比（41.7％）。口服尼莫地平的平均剂量为每4小时1 mg / kg，与低血压高发生率相关，需要干预或调整剂量。尼莫地平治疗的临床结果各不相同;血管痉挛的证据为67％，新发梗死为33％，再出血为17％。在三分之二的人中，功能和认知功能障碍很小，其余的人则没有。所有患者存活直至出院。结论：儿童蛛网膜下腔出血后口服尼莫地平不能消除血管痉挛，再出血或梗塞，并伴有明显的低血压。然而，相对于接受尼莫地平的成年人，临床结果似乎是有利的。有必要进行剂量滴定的进一步研究。

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