A 55-year-old woman is brought to the emergency department for a severe, abrupt-onset headache, light-sensitivity, and confusion that began 30 minutes ago. Neurological examination shows no meningeal signs or focal neurological deficits. A CT scan of the head shows hyperdensity between the arachnoid mater and the pia mater. The patient is admitted to the critical care unit for further management. On the fourth day after admission, he experiences new-onset weakness in the right arm and leg. Which of the following medications could have most likely prevented the neurological complications this patient developed in the hospital?

Question

A 55-year-old woman is brought to the emergency department for a severe, abrupt-onset headache, light-sensitivity, and confusion that began 30 minutes ago. Neurological examination shows no meningeal signs or focal neurological deficits. A CT scan of the head shows hyperdensity between the arachnoid mater and the pia mater.   The patient is admitted to the critical care unit for further management.  On the fourth day after admission, he experiences new-onset weakness in the right arm and leg.  Which of the following medications could have most likely prevented the neurological complications this patient developed in the hospital?

Quizplus · Accepted Answer

Eductional Objective: Oral nimodipine should be given after subarachnoid hemorrhage to prevent vasospasm, which can lead to ischemic stroke. This patient's sudden-onset neurologic deficit 4 days after SAH is a common presentation of vasospasm, which is a complication in - 30% of SAH cases and is more common with aneurysms. Nimodipine, a selective calcium channel blocker, improves outcomes in patients with cerebral vasospasm by inducing cerebral vasodilation and decreasing calcium-dependent excitotoxicity

A 55-Year-Old Woman Is Brought to the Emergency Department for a Severe