Lumbar Drain With Intrathecal Nicardipine in Aneurysmal Subarachnoid Hemorrhage

The purpose of this study is to determine the effectiveness of prophylactic administration of intra-thecal nicardipine though lumbar cerebrospinal fluid drain in prevention of symptomatic vasospasm in patients with subarachnoid hemorrhage due to rupture of cerebral aneurysms.

Inclusion Criteria: * Age ≥18 years * Aneurysmal subarachnoid hemorrhage with Hunt and Hess score 3 or less * Patient or legal authorized representative available to sign the informed consent form * Pre-morbid modified Rankin scale of 0 or 1. * Patients who have lumbar drain placed or planned for cerebrospinal fluid diversion per standard of care * Patients who are able to be randomized within 72 hours from arrival with aneurysmal subarachnoid hemorrhage or within 24 hours from lumbar drain placement Exclusion Criteria: * Pregnant females * Subarachnoid hemorrhage (SAH) with hunt and hess scale of \>3 * SAH due to etiology other than aneurysmal rupture * Any contraindications in patients receiving calcium channel antagonists like hypersensitivity to dihydropyridines * Active central nerve infection (CNS) infection or high suspicion of CNS infection * Hemodynamic instability preventing the use of Nicardipine