Riva R, et al. - Among 23 patients with aneurysmal subarachnoid hemorrhage, researchers assessed plasma and CSF nimodipine concentrations and their correlation with the clinical result. The infusion of nimodipine began at 1 mg/h and increased to 2 mg/h and continued in surviving patients for up to 21 days. At least after 24 hours of stable nimodipine dosage, arterial and CSF samples were gathered. The modified Rankin scale evaluated the clinical outcome at 9 months. Doses and arterial concentrations were not correlated with the clinical outcome and were not linked to the occurrence of delayed cerebral ischemia. After 9 months of hemorrhage, however, patients with no significant disability exhibited significantly higher CSF concentrations of nimodipine and CSF-to-plasma ratios vs patients with some degree of disability or death. In patients with aneurysmal subarachnoid hemorrhage, cerebrospinal fluid nimodipine concentrations measured during hospital drug infusion exhibited a relationship with long-term clinical outcome. These very preliminary data indicate that surveillance of CSF concentrations may have some significance in the management of these patients.