Evaluation of the effect of Cilnidipine on cerebral vasospasm in an experimental subarachnoid hemorrhage model

Objective: Cerebral vasospasm is one of the most significant complications affecting mortality and morbidity in patients with subarachnoid hemorrhage. Due to the incomplete understanding of its pathophysiology, prevention, and treatment, it presents a serious problem in neurosurgical practice. In this study, the effectiveness of cilnidipine in the treatment of vasospasm was evaluated by comparing it with nimodipine in a rat model of subarachnoid hemorrhage. Materials and Metods: A total of 40 adult Wistar rats weighing 250-300g were used in this experimental study. Subarachnoid hemorrhage was induced using a single hemorrhage model. The rats were divided into 5 groups: Group 1 (Control), Group 2 (Sham), Group 3 (Nimodipine 0.2mg/kg), Group 4 (Cilnidipine 0.1mg/kg), and Group 5 (Cilnidipine 0.2mg/kg). The drugs were administered intraperitoneally twice with a 12-hour interval. After 24 hours, the rats were sacrificed, and histopathological analysis was performed to measure the diameter and wall thickness of the basilar artery. Apoptosis was evaluated using the TUNEL method in the hippocampus, dentate gyrus, and cortex. Results: The effects of Cilnidipine on arterial diameter, wall thickness, and apoptosis were evaluated in rats with subarachnoid hemorrhage. Statistical analysis showed that Cilnidipine was effective in preventing vasospasm. Compared to Nimodipine, it had similar effects on arterial diameter and wall thickness. However, it was found to be more effective in preventing apoptosis. Conclusion: This study demonstrates that cilnidipine can be used for preventing and treating vasospasm following subarachnoid hemorrhage, and it has a similar efficacy to nimodipine in terms of arteriolar diameter and wall thickness. However, it appears to be more effective in preventing apoptosis. Nevertheless, further experimental and clinical studies are necessary to enable the clinical use of cilnidipine. Key Words: Subarachnoid hemorrhage, cerebral vasospasm, calcium channel blocker, nimodipine, cilnidipine