• Nimotop

• Calcium channel blocker

• Hypertension

• Traumatic brain injury

• Reversible cerebral vasoconstrictive syndromes

• Cardiac and vascular smooth muscle contraction depends on movement of calcium through L-type calcium channels into cells, which is inhibited by nimodipine. In animals, nimodipine has a greater effect on cerebral arteries compared with other calcium channel blockers, probably because it is more lipophilic. There is no angiographic evidence that this is correct

• Within hours for both SAH vasospasm and hypertension

• Prevents delayed ischemic complications after SAH caused by vasospasm, improves recovery time and reduces disability

• Typically used for 3 weeks

• Continue supportive care. Alternative but unproven treatments include statins and magnesium sulfate

• Treatment of SAH should take place in a medical center with experience and 24-hour physician availability

• Occlude the aneurysm in SAH by surgery or coiling

• Do not treat hypertension aggressively

• Normovolemia is preferred

• Treat hyperglycemia and use measures to avoid deep vein thrombosis

• Monitor blood pressure and heart rate