A 52-year-old woman is diagnosed with aneurysmal subarachnoid hemorrhage. After securing the aneurysm, which oral agent should be started to reduce the risk of delayed cerebral ischemia?

• A Heparin
• B Nicardipine
• C Aspirin
• D Nimodipine ✓

Explanation

Oral nimodipine, 60 mg every 4 hours for 21 days, improves outcome after aneurysmal subarachnoid hemorrhage by reducing delayed cerebral ischemia from vasospasm; it is the only pharmacologic agent proven to do so. Nicardipine is used as an intra-arterial or infusion agent for angiographic spasm but has no proven mortality benefit. Antithrombotics have no role in vasospasm prophylaxis here.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.