{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:20:34Z","timestamp":1783776034263,"version":"3.55.0"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1993,4]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Calcium antagonist drugs were proposed for use in patients with recent aneurysmal subarachnoid hemorrhage (SAH) because of their ability to block the effects of a wide variety of vasoconstrictor substances on cerebral arteries <jats:italic>in vitro.<\/jats:italic> It was suggested that these agents might, therefore, be useful in ameliorating cerebral vasospasm and its ischemic consequences which frequently complicate SAH. This hypothesis was tested in an arm of a randomized double-blind placebo-controlled trial of high-dose intravenous nicardipine in patients with recently ruptured aneurysms. Participating investigators were required to send selected copies of all admission and follow-up angiograms obtained between Days 7 and 11 following hemorrhage (the peak period of risk for vasospasm) to the Central Registry of the Cooperative Aneurysm Study for blinded interpretation and review for the presence and severity of angiographic vasospasm. In centers with transcranial Doppler ultrasound (TCD) capabilities, middle cerebral artery (MCA) mean flow velocities were measured and recorded.<\/jats:p>\n<jats:p content-type=\"fine-print\">Angiograms obtained between Days 7 and 11 were available for 103 (23%) of 449 patients receiving nicardipine and 121 (26%) of 457 receiving placebo. There was a balance of prognostic factors for vasospasm between the groups. Fifty-one percent of placebo-treated patients had moderate or severe vasospasm on \u201cDay 7\u201311 angiograms\u201d compared to 33% of nicardipine-treated patients. This difference is statistically significant (p &lt; 0.01). Sixty-seven (49%) of 137 placebo-treated patients examined with TCD between Days 7 and 11 had mean MCA flow velocities exceeding 120 cm\/sec compared to 26 (23%) of 112 nicardipine-treated patients (significant difference, p &lt; 0.001). These data suggest that high-dose intravenous nicardipine reduces the incidence and severity of delayed cerebral arterial narrowing in patients following aneurysmal SAH.<\/jats:p>","DOI":"10.3171\/jns.1993.78.4.0548","type":"journal-article","created":{"date-parts":[[2009,5,27]],"date-time":"2009-05-27T15:15:10Z","timestamp":1243437310000},"page":"548-553","source":"Crossref","is-referenced-by-count":125,"title":["A randomized trial of nicardipine in subarachnoid hemorrhage: angiographic and transcranial Doppler ultrasound results"],"prefix":"10.3171","volume":"78","author":[{"given":"E. Clarke","family":"Haley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal F.","family":"Kassell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Torner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg","first-page":"37","article-title":"Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound.","volume":"60","author":"Aaslid","year":"1984"},{"key":"b2","series-title":"J Neurosurg","first-page":"769","article-title":"Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries.","volume":"57","author":"Aaslid","year":"1982"},{"key":"b3","series-title":"Neurology","first-page":"1586","article-title":"Predicting cerebral ischemia after aneurysmal subarachnoid hemorrhage: influences of clinical condition, CT results, and antifibrinolytic therapy. A report of the Cooperative Aneurysm Study.","volume":"37","author":"Adams","year":"1987"},{"key":"b4","series-title":"Neurosurgery","first-page":"142","article-title":"Cerebral arterial spasm: a discussion of present and future research.","volume":"1","author":"Allen","year":"1977"},{"key":"b5","series-title":"N Engl J Med","first-page":"619","article-title":"Cerebral arterial spasm \u2014 a controlled trial of nimodipine in patients with subarachnoid hemorrhage.","volume":"308","author":"Allen","year":"1983"},{"key":"b6","series-title":"Neurology","first-page":"680","article-title":"Assessment: transcranial Doppler.","volume":"40","year":"1990"},{"key":"b7","series-title":"J Neurosurg","first-page":"393","article-title":"Dose-escalation study of intravenous nicardipine in patients with aneurysmal subarachnoid hemorrhage.","volume":"68","author":"Flamm","year":"1988"},{"key":"b8","series-title":"J Neurosurg","first-page":"537","article-title":"A randomized controlled trial of high-dose intravenous nicardipine in aneurysmal subarachnoid hemorrhage: A report of the Cooperative Aneurysm Study.","volume":"78","author":"Haley","year":"1993"},{"key":"b9","series-title":"Can J Neurol Sci","first-page":"411","article-title":"Transcranial Doppler studies in aneurysm patients.","volume":"16","author":"Hutchison","year":"1989"},{"key":"b10","series-title":"Acta Neurochir Suppl","first-page":"81","article-title":"Cerebral vasospasm after subarachnoid haemorrhage investigated by means of transcranial Doppler ultrasound.","volume":"42","author":"Lindegaard","year":"1988"},{"key":"b11","series-title":"Eur Heart J","first-page":"41","article-title":"Early intervention with nimodipine in subarachnoid haemorrhage.","volume":"8","author":"Neil-Dwyer","year":"1987"},{"key":"b12","series-title":"J Neurosurg","first-page":"505","article-title":"Nimodipine treatment in poor-grade aneurysm patients. Results of a multicenter double-blind placebo-controlled trial.","volume":"68","author":"Petruk","year":"1988"},{"key":"b13","series-title":"Acta Neurochir","first-page":"110","article-title":"Prevention of vasospasm in subarachnoid haemorrhage. A controlled study with nimodipine.","volume":"82","author":"Philippon","year":"1986"},{"key":"b14","series-title":"Br Med J","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","year":"1989"},{"key":"b15","series-title":"Cerebrovasc Brain Metab Rev","first-page":"205","article-title":"Calcium antagonists in the management of subarachnoid hemorrhage.","volume":"2","author":"Robinson","year":"1990"},{"key":"b16","series-title":"J Neurosurg","first-page":"571","article-title":"Effect of AT877 on cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Results of a prospective placebo-controlled double-blind trial.","volume":"76","author":"Shibuya","year":"1992"},{"key":"b17","series-title":"CRC Handbook of Sample Size Guidelines for Clinical Trials.","first-page":"18","author":"Shuster","year":"1990"},{"key":"b18","series-title":"Neurology","first-page":"1514","article-title":"Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage.","volume":"39","author":"Sloan","year":"1989"},{"key":"b19","series-title":"Statistical Methods","first-page":"56","author":"Snedecor","year":"1980"},{"key":"b20","series-title":"Can J Neurol Sci","first-page":"239","article-title":"Calcium antagonists, cerebral ischemia and vasospasm.","volume":"11","author":"Weir","year":"1984"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/78\/4\/article-p548.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/78\/4\/article-p548.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/78\/4\/article-p548.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T21:08:02Z","timestamp":1679260082000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/78\/4\/article-p548.xml"}},"subtitle":["A report of the Cooperative Aneurysm Study"],"short-title":[],"issued":{"date-parts":[[1993,4]]},"references-count":20,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/jns.1993.78.4.0548","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1993,4]]}}}