Browsing by Author "Alharbi, Yousef Essa"

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Advances in nimodipine therapy and comparative efficacy of Nimodipine formulations in sub-arachnoid haemorrhage management- A systematic review
(Saudi Digital Library, 2025) Alharbi, Yousef Essa; Zolfaghari, Parjam
Subarachnoid haemorrhage (SAH), often caused by aneurysm rupture, is a critical condition with high morbidity and mortality. Management aims to prevent complications like vasospasm and delayed cerebral ischemia (DCI). Nimodipine, a calcium channel blocker, is the standard treatment to reduce vasospasm, with new routes of administration being explored for improved efficacy. We conducted a systematic review and meta-analysis to evaluate the efficacy of different Nimodipine delivery methods in aneurysmal SAH (aSAH) patients. PubMed, Embase, and Cochrane were searched for studies published in the last 20 years. Studies without full text or in non-English languages were excluded. Thirteen studies met the inclusion criteria. Augmentation of Nimodipine with magnesium showed benefits, though limited by study size. Intravenous Nimodipine achieved more stable serum concentrations than oral forms, while intra-arterial and intraventricular formulations, like EG-1962, demonstrated potential in reducing vasospasm but lacked sustained results in larger trials. Oral Nimodipine remains the preferred option for stable patients, while intravenous delivery is recommended for severe cases. Intraventricular and intra-arterial forms hold promise but require further research for routine clinical application.
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