Isolated diastolic hypotension: A unique complication of intra-arterial nimodipine infusion

Computerized tomography (CT) scan and digital subtraction angiography (DSA) of his brain showed sub-arachnoid haemorrhage (SAH) and anterior communicating artery aneurysm respectively. Repeat CT scan did not show any new abnormality but transcranial Doppler (TCD) study showed increased mean flow vel...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2020-02, Vol.59, p.1-1
Main Authors: Mitra, Ranadhir, Dube, Surya K., Jain, Varun
Format: Article
Language:English
Subjects:
Aged
Angiography, Digital Subtraction
Anterior Cerebral Artery - diagnostic imaging
Blood pressure
Blood Pressure - drug effects
Diastole - drug effects
Electrocardiography
Heart rate
Hemostasis, Surgical - adverse effects
Humans
Hypotension - chemically induced
Hypotension - diagnosis
Hypotension - drug therapy
Infusions, Intra-Arterial
Intracranial Aneurysm - complications
Intracranial Aneurysm - surgery
Ischemia
Male
Nimodipine - adverse effects
Phenylephrine - administration & dosage
Subarachnoid Hemorrhage - etiology
Subarachnoid Hemorrhage - surgery
Ultrasonography, Doppler, Transcranial
Vasoconstrictor Agents - administration & dosage
Vasodilator Agents - adverse effects
Vasospasm, Intracranial - diagnosis
Vasospasm, Intracranial - drug therapy
Vasospasm, Intracranial - etiology
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Description
Summary:Computerized tomography (CT) scan and digital subtraction angiography (DSA) of his brain showed sub-arachnoid haemorrhage (SAH) and anterior communicating artery aneurysm respectively. Repeat CT scan did not show any new abnormality but transcranial Doppler (TCD) study showed increased mean flow velocities in bilateral anterior cerebral arteries (ACAs). The ST segment depression in our patient could have been due to reduction of coronary blood flow (which is dependent on diastole and DBP) causing sub-endocardial ischaemia.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2019.05.011