{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T13:54:12Z","timestamp":1771509252349,"version":"3.50.1"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"14","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Delayed cerebral ischemia (DCI) and cerebral vasospasm (CV) are severe complications of spontaneous subarachnoid hemorrhage (SAH) contributing to an inferior outcome. Rescue therapies include intra-arterial balloon angioplasty and repetitive and finally continuous intra-arterial nimodipine infusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>In the presented case, a young female patient with fulminant refractory DCI and CV, despite induced hypertension and nimodipine application, was treated with three-vessel continuous intra-arterial infusion and additional repetitive angioplasty of the basilar and middle cerebral arteries using a stent retriever, leading to a good clinical outcome. Additional stent retriever dilatation to continuous intra-arterial nimodipine application in three vessel territories may represent a further escalation step in the rescue therapy for severe CV and DCI after SAH. Montreal Cognitive Assessment and SF-36 testing showed satisfactory results 3 months after initial treatment with intra-arterial nimodipine catheters in three vessel territory circulations and additional stent retriever vasodilation of severe CV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>We report a unique rescue strategy involving implantation of an additional intra-arterial catheter into the vertebral artery and repetitive stent retriever dilatations of the middle cerebral and basilar arteries as an extra therapy for continuous intra-arterial nimodipine vaspospasmolytic therapy in three vessel territories, resulting in a very good clinical outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23339","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T21:27:20Z","timestamp":1696282040000},"source":"Crossref","is-referenced-by-count":1,"title":["Combined stent retriever angioplasty and continuous intra-arterial nimodipine infusion as salvage therapy for cerebral vasospasm and delayed cerebral ischemia after subarachnoid hemorrhage: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Andreas","family":"Knoll","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor","family":"Durner","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Braun","sequence":"additional","affiliation":[{"name":"Neuroradiology, University of Ulm, G\u00fcnzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernd","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Neuroradiology, University of Ulm, G\u00fcnzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian Rainer","family":"Wirtz","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrej","family":"Pala","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"BioMed Res Int","first-page":"384342","article-title":"Inflammation, vasospasm, and brain injury after subarachnoid hemorrhage","volume":"2014","author":"Miller BA","year":"2014","unstructured":"Miller BA, Turan N, Chau M, Pradilla G. Inflammation, vasospasm, and brain injury after subarachnoid hemorrhage. BioMed Res Int. 2014;2014(2):384342."},{"issue":"10069","key":"b2","series-title":"Lancet","first-page":"655","article-title":"Spontaneous subarachnoid haemorrhage","volume":"389","author":"Macdonald RL","year":"2017","unstructured":"Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet. 2017;389(10069):655\u2013666."},{"key":"b3","series-title":"Clin Neurol Neurosurg","first-page":"106","article-title":"Results of interdisciplinary management of 693 patients with aneurysmal subarachnoid hemorrhage: clinical outcome and relevant prognostic factors","volume":"167","author":"AlMatter M","year":"2018","unstructured":"AlMatter M, Aguilar P\u00e9reza M, Bhogal P, Hellstern V, Ganslandt O, Henkes H. Results of interdisciplinary management of 693 patients with aneurysmal subarachnoid hemorrhage: clinical outcome and relevant prognostic factors. Clin Neurol Neurosurg. 2018;167:106\u2013111."},{"issue":"6674","key":"b4","series-title":"BMJ","first-page":"636","article-title":"Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial","volume":"298","author":"Pickard JD","year":"1989","unstructured":"Pickard JD, Murray GD, Illingworth R,  Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial. BMJ. 1989;298(6674):636\u2013642."},{"issue":"3","key":"b5","series-title":"Cochrane Database Syst Rev","first-page":"CD000277","article-title":"Calcium antagonists for aneurysmal subarachnoid haemorrhage","volume":"2007","author":"Mees SD","year":"2007","unstructured":"Mees SD, Rinkel GJ, Feigin VL,  Calcium antagonists for aneurysmal subarachnoid haemorrhage. 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J Pharm Pharm Sci. 2020;23(1):100\u2013108."},{"issue":"2","key":"b7","series-title":"BioMed Res Int","first-page":"970741","article-title":"Continuous selective intra-arterial application of nimodipine in refractory cerebral vasospasm due to aneurysmal subarachnoid hemorrhage","volume":"2014","author":"Ott S","year":"2014","unstructured":"Ott S, Jedlicka S, Wolf S,  Continuous selective intra-arterial application of nimodipine in refractory cerebral vasospasm due to aneurysmal subarachnoid hemorrhage. BioMed Res Int. 2014;2014(2):970741."},{"issue":"6","key":"b8","series-title":"AJNR Am J Neuroradiol","first-page":"1053","article-title":"Intra-arterial nimodipine for severe cerebral vasospasm after aneurysmal subarachnoid hemorrhage: influence on clinical course and cerebral perfusion","volume":"29","author":"H\u00e4nggi D","year":"2008","unstructured":"H\u00e4nggi D, Turowski B, Beseoglu K, Yong M, Steiger HJ. 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