A 48-year-old woman develops a sudden severe headache with neck stiffness and photophobia. CT shows diffuse subarachnoid blood. She is drowsy but obeys commands and has no focal deficit. Cerebral angiography confirms a ruptured anterior communicating artery aneurysm. She is started on nimodipine. The main purpose of nimodipine is to:

• A Prevent rebleeding from the aneurysm
• B Reduce delayed cerebral ischaemia due to vasospasm ✓
• C Lower the risk of acute hydrocephalus
• D Treat hyponatraemia from cerebral salt wasting

Explanation

Oral nimodipine 60 mg every 4 hours for 21 days is standard after aneurysmal subarachnoid haemorrhage because it reduces delayed cerebral ischaemia from arterial vasospasm, which peaks between days 4 and 14. Rebleeding is prevented by early aneurysm securing with clipping or coiling, not by calcium channel blockade. Nimodipine does not influence acute hydrocephalus 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.