Key result
IV hydroxocobalamin resolves nimodipine-induced refractory vasoplegia within 2 hours in a single patient.
Case Report (n=1)
This case report describes a 59-year-old woman who developed refractory vasoplegia following an acute aneurysmal subarachnoid hemorrhage.
May warrant consideration as rescue therapy in nimodipine-induced vasoplegia; leaves open need for prospective trials before broader adoption.
The CaseA 59-year-old white woman presented to our emergency department with the worst headache of her life and altered mental status.Medical history included intravenous drug abuse, hypertension, and hepatitis C cirrhosis.Her neurological examination was consistent with a Glasgow Coma Scale score of 12 (E3V4M5), inability to follow commands and left third cranial nerve palsy.Computed tomography (CT) head and CT angiogram revealed diffuse subarachnoid hemorrhage (SAH) (Hunt and Hess grade 3, modified Fisher 4) and a left posterior communicating artery (PCOM) aneurysm.
No takes yet. Share an insight, caveat, or question.
Ramanan et al. (2025) conducted a case report in Acute aneurysmal subarachnoid hemorrhage with refractory vasoplegia (n=1). Hydroxocobalamin was evaluated on Hemodynamic improvement. Intravenous hydroxocobalamin administration resulted in rapid hemodynamic improvement and weaning of all vasopressors within 2 hours in a patient with nimodipine-induced refractory vasoplegia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: