Nimodipine is commonly used in the management of vasospasm after which type of stroke?

Nimodipine is commonly used in the management of vasospasm after which type of stroke?

• A. Subarachnoid hemorrhage
• B. Ischemic stroke in MCA
• C. Intracerebral hemorrhage without subarachnoid bleeding
• D. Epidural hematoma

Answer: (A)

Vasospasm after a subarachnoid hemorrhage is a delayed narrowing of cerebral arteries caused by blood and its breakdown products in the subarachnoid space, which can lead to delayed cerebral ischemia. Nimodipine is used because it is a calcium channel blocker with relatively selective effects on cerebral vessels, helping to prevent and lessen the severity of this vasospasm. By reducing the degree of vasoconstriction, nimodipine improves cerebral perfusion and outcomes after SAH. It’s given orally for several weeks after the bleed, and its benefit is specifically tied to this vasospasm risk pattern, not the other stroke types listed. Continuous monitoring is needed for potential hypotension, and IV administration is generally avoided due to that risk.

Vasospasm after a subarachnoid hemorrhage is a delayed narrowing of cerebral arteries caused by blood and its breakdown products in the subarachnoid space, which can lead to delayed cerebral ischemia. Nimodipine is used because it is a calcium channel blocker with relatively selective effects on cerebral vessels, helping to prevent and lessen the severity of this vasospasm. By reducing the degree of vasoconstriction, nimodipine improves cerebral perfusion and outcomes after SAH. It’s given orally for several weeks after the bleed, and its benefit is specifically tied to this vasospasm risk pattern, not the other stroke types listed. Continuous monitoring is needed for potential hypotension, and IV administration is generally avoided due to that risk.