Hemos revisado 170 pacientes con hemorragia subaracnoidea (HSA) de causa no traumática atendidos en nuestro Servicio.

Setenta y dos de ellos ingresaron entre 1989 y 1991 (Grupo A) y 98 lo hicieron entre 1969 y 1979 (Grupo B). En 123 casos se confirmó la existencia de aneurisma (46 y 77 en los grupos A y B respectivamente) y 103 pacientes fueron intervenidos. En el Grupo A se usó nimodipina en 44 casos. Se ha comparado la aparición de resangrado, isquemia, hidrocefalia y exitus en ambos grupos y, dentro del Grupo A, entre los tratados y no tratados con nimodipina, obteniendo los siguientes resultados: En el Grupo A, en los 44 pacientes que recibieron nimodipina se observaron seis resangrados, 7 isquemias y 3 exitus. En los no tratados se registraron 2 resangrados, 1 isquemia, 4 hidrocefalias y 11 exitus. En los 98 pacientes del Grupo B se registraron 12 resangrados, 17 isquemias, 5 hidrocefalias y 28 exitus.

Los resultados han mejorado pese a seguir usando un tratamiento quirúrgico diferido. El papel de la nimodipina no queda suficientemente claro en este estudio.

A series of 170 patients with primary subarachnoid hemorrhage treated at our Unit is analyzed. 72 patients were received between 1989 and 1991 (Group A), and 98 were admitted between 1969 and 1979 (Group B). Aneurysms were confirmed in 123 cases (46 and 77 for each group), and 103 were operated. Nimodipine was employed in 44 patients belonging to Group A. The presence of rebleeding, ischemia, hydrocephalus and exitus has been compared between both groups, and into patients of Group A, between those treated with nimodipine and those without nimodipine. In patients of Group A treated with nimodipine there were 6 with rebleedings, 7 with brain ischemia, and 3 deaths. In those who did not receive nimodipine we observed 2 patients with rebleeding, 1 with brain ischemia, 4 with hydrocephalus, and 11 deaths. In patients of Group B there were 12 with rebleeding, 17 with brain ischemia, five with hydrocephalus and 28 deaths.

With the passage of time, there has been an improvement in our results in spite of the use of delayed surgery. The role played by nimodipine in preventing cerebral ischemia is not clear enough in our study.