Which pharmacological regimen is the established oral therapy proven to improve neurological outcome after aneurysmal subarachnoid haemorrhage?

• A Nimodipine 60 mg orally every 4 hours for 21 days ✓
• B Intravenous nicardipine infusion titrated to blood pressure for 21 days
• C Intravenous magnesium sulphate infusion for 14 days
• D Intra-arterial papaverine administered daily for 14 days

Explanation

Oral nimodipine 60 mg every 4 hours for 21 days, started within 96 hours of the bleed, remains the only pharmacological agent shown in randomised trials to improve outcome after aneurysmal SAH. Its benefit appears related to neuroprotection rather than reversal of angiographic spasm. Intravenous nicardipine controls blood pressure but has not demonstrated improved outcome, and papaverine is a rescue endovascular agent, not routine therapy.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.