Effects of nimodipine on cerebral hemodynamics, and prognosis of diffuse axonal injury patients

Objectives: To evaluate the effects of nimodipineon hemodynamic state, vasospasm, and short timeprognosis of diffuse axonal injury (DAI) patients.Methods: In a prospective, clinical trial doubleblind study, 40 DAI patients with Glasgow comascale of 5-8 were selected and randomly divided into2 equal groups. The first group was treated with 60mg of nimodipine every 4 hours immediately afteradmission, and the control group did not receivethis treatment. Mean blood flow velocity (MFV)and pulsatility index of both middle cerebral arterieswere measured using transcranial Doppler on the 1st,3rd, and 10th days of admission. Glasgow outcomescale was evaluated one month after admission. Thisstudy was performed from June 2003 to June 2004at Imam Medical Center, Tabriz, Iran.Results: There were significant differences inMFV among the 3 transcranial Doppler, whichdemonstrated hemodynamic changes in thesepatients. Nimodipine did not have any significantdifference on MFV between the treatment andcontrol groups. In the nimodipine group, 45% hadgood prognosis (30% in the control group) andnobody had vasospasm on the 10th day Dopplerstudy (15% in the control group), although itdid not show any statistical significant differencebetween them.Conclusion: Nimodipine improved the prognosisand decreased vasospasm, however, there was nostatistical difference. Therefore, we suggest furtherstudies in a larger number of DAI patients.