A 52-year-old woman is diagnosed with aneurysmal subarachnoid haemorrhage. The neurosurgeon prescribes oral nimodipine 60 mg every 4 hours for 21 days. What is the rationale for this drug?

• A It prevents rebleeding of the ruptured aneurysm
• B It lowers intracranial pressure by reducing CSF production
• C It reduces the incidence and severity of delayed cerebral ischaemia from vasospasm ✓
• D It prevents hyponatraemia from cerebral salt wasting

Explanation

Delayed cerebral ischaemia from arterial vasospasm typically occurs between days 4 and 14 after subarachnoid haemorrhage and is a major cause of death and disability. Oral nimodipine, a dihydropyridine calcium channel blocker, improves outcomes in randomised trials and is standard care. It does not prevent rebleeding, which requires aneurysm occlusion by clipping or coiling, nor does it affect CSF production or sodium handling.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.