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Verapamil in the treatment of reversible cerebral vasoconstriction syndrome: A systematic review.
Collins, Luke; Lam, Lydia; Kleinig, Oliver; Proudman, William; Zhang, Ruyi; Bagster, Michelle; Kovoor, Joshua; Gupta, Aashray; Goh, Rudy; Bacchi, Stephen; Schultz, David; Kleinig, Timothy.
Afiliación
  • Collins L; Flinders Medical Centre, Bedford Park, SA 5042, Australia. Electronic address: luke.collins@sa.gov.au.
  • Lam L; University of Adelaide, Adelaide, SA 5005, Australia.
  • Kleinig O; University of Adelaide, Adelaide, SA 5005, Australia.
  • Proudman W; University of Adelaide, Adelaide, SA 5005, Australia.
  • Zhang R; Flinders Medical Centre, Bedford Park, SA 5042, Australia.
  • Bagster M; University of Adelaide, Adelaide, SA 5005, Australia; Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia.
  • Kovoor J; University of Adelaide, Adelaide, SA 5005, Australia; Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
  • Gupta A; University of Adelaide, Adelaide, SA 5005, Australia.
  • Goh R; Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia.
  • Bacchi S; Flinders Medical Centre, Bedford Park, SA 5042, Australia; University of Adelaide, Adelaide, SA 5005, Australia; Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
  • Schultz D; Flinders Medical Centre, Bedford Park, SA 5042, Australia.
  • Kleinig T; University of Adelaide, Adelaide, SA 5005, Australia; Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
J Clin Neurosci ; 113: 130-141, 2023 Jul.
Article en En | MEDLINE | ID: mdl-37267876
INTRODUCTION: Extrapolating from efficacy in subarachnoid haemorrhage (SAH), nimodipine has been used as a treatment for reversible cerebral vasoconstriction syndrome (RCVS). However, 4-hourly dosing is a practical limitation and verapamil has been proposed as an alternative. The potential efficacy, adverse effects, preferred dosing and formulation of verapamil for RCVS have not been systematically reviewed previously. METHOD: A systematic review was conducted of the databases PubMed, EMBASE, and the Cochrane Library from inception to July 2022 for peer-reviewed articles describing the use of verapamil for RCVS. This systematic review adheres to the PRISMA guidelines and was registered on PROSPERO. RESULTS: There were 58 articles included in the review, which included 56 patients with RCVS treated with oral verapamil and 15 patients treated with intra-arterial verapamil. The most common oral verapamil dosing regimen was controlled release 120 mg once daily. There were 54/56 patients described to have improvement in headache following oral verapamil and one patient who died from worsening RCVS. Only 2/56 patients noted possible adverse effects with oral verapamil, with none requiring discontinuation. There was one case of hypotension from combined oral and intra-arterial verapamil. Vascular complications including ischaemic and haemorrhagic stroke were recorded in 33/56 patients. RCVS recurrence was described in 9 patients, with 2 cases upon weaning oral verapamil. CONCLUSIONS: While no randomised studies exist to support the use of verapamil in RCVS, observational data support a possible clinical benefit. Verapamil appears well tolerated in this setting and represents a reasonable treatment option. Randomised controlled trials including comparison with nimodipine are warranted.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trastornos Cerebrovasculares / Vasoespasmo Intracraneal Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Systematic_reviews Límite: Humans Idioma: En Revista: J Clin Neurosci Asunto de la revista: NEUROLOGIA Año: 2023 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Trastornos Cerebrovasculares / Vasoespasmo Intracraneal Tipo de estudio: Clinical_trials / Etiology_studies / Guideline / Systematic_reviews Límite: Humans Idioma: En Revista: J Clin Neurosci Asunto de la revista: NEUROLOGIA Año: 2023 Tipo del documento: Article