THE EFFECT OF NIMODIPINE ON ICP AND CBF IN PATIENTS WITH NORMAL-PRESSURE HYDROCEPHALUS

Eight patients with normal-pressure hydrocephalus (NPH) were studied. The resting mean arterial blood pressure (MABP) was 100 (90-125)mmHg and the mean intracranial pressure (ICP) was 11 (5-17)mmHg. ICP and MABP were continuously measured intraventricularly and intra-arterially, respectively. Changes in global cerebral blood flow (CBF) were estimated by the arteriovenous oxygen difference method. Intravenous nimodipine (15 microgram/kg/hour) was given in the first 2 hours and 30 microgram/kg/hour in the next 2 hours. MABP was reduced 23 (4-47)mmHg (p<0.05). ICP was increased 3 (0-10)mmHg (p < 0.05). CBF was unchanged in the group on the whole, but in 4 of patients a major drop in perfusion pressure was seen, and CBF decreased 6, 11, 23 and 34%, respectively. Thus these findings underline the importance of maintaining the perfusion pressure under treatment with nimodipine. © 1990 Springer-Verlag.