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Physiological abnormalities are a worthwhile target
Delayed cerebral ischaemia (DCI) affects more than one quarter of patients between 3 and 14 days after the onset of their aneurysmal subarachnoid haemorrhage, and accounts for about one third of patients who are dead or dependent as a result of the haemorrhage. Despite the importance of DCI, little can be done to prevent it: only calcium antagonists are supported by good evidence, and the effectiveness of nimodipine is modest (20 patients need to be treated to prevent one poor outcome).1 Future hope is offered only by the window of opportunity between subarachnoid haemorrhage and DCI onset, and sufficient clinical research …
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