What is the purpose of nimodipine in subarachnoid hemorrhage and what monitoring is required?

• A. Prophylaxis against cerebral vasospasm to prevent delayed ischemia; monitor BP and ensure adequate cerebral perfusion; adjust dosing as needed.
• B. Nimodipine reduces fever after SAH.
• C. Used to treat seizures after SAH; monitor EEG.
• D. Primarily lowers intracranial pressure.

Answer: (B)

Nimodipine after subarachnoid hemorrhage is used to prevent cerebral vasospasm, which can lead to delayed cerebral ischemia and poor outcomes. By dilating cerebral arteries, it helps maintain blood flow to brain tissue that is at risk after the hemorrhage.

Because nimodipine can lower systemic blood pressure, careful monitoring of blood pressure is essential to ensure the brain continues to receive adequate perfusion. If BP drops too much, dosing may need adjustment and the patient’s hemodynamics must be stabilized. Nimodipine is given orally or via a feeding tube, not by IV administration, due to the risk of dangerous hypotension. Clinically, you’d also watch for any signs of vasospasm or neurological change and monitor for common adverse effects like hypotension or bradycardia. It does not reduce fever, treat seizures, or lower intracranial pressure.