The efficacy and safety of fasudil hydrochloride, a novel protein kinase 
inhibitor, were evaluated for the treatment of cerebral vasospasm and associated 
cerebral ischemic symptoms in patients with ruptured cerebral aneurysm. This 
randomized open trial with nimodipine as the control included 72 patients who 
underwent subarachnoid hemorrhage surgery for ruptured cerebral aneurysm of Hunt 
and Hess grades I to IV. For 14 days following surgery, patients were 
administered either 30 mg of fasudil hydrochloride by intravenous injection over 
a period of 30 minutes three times a day or 1 mg/hr of nimodipine by continuous 
intravenous infusion. Fasudil hydrochloride and nimodipine both showed 
inhibitory effects on cerebral vasospasm. The incidence of symptomatic vasospasm 
was five of 33 patients in the fasudil group and nine of 32 patients in the 
nimodipine group. Good recovery evaluated by the Glasgow Outcome Scale was 
achieved by 23 of 33 patients in the fasudil group and 19 of 34 patients in the 
nimodipine group. Both drugs significantly improved consciousness levels and 
neurological deficits such as aphasia. However, fasudil hydrochloride improved 
motor disturbance more than nimodipine. Adverse reactions occurred in 13 of 37 
patients receiving fasudil hydrochloride and 15 of 35 patients receiving 
nimodipine. There were no serious adverse events in the fasudil group. The 
results of this clinical trial indicate that fasudil hydrochloride is a safe and 
efficient agent for suppressing cerebral vasospasm after subarachnoid hemorrhage 
surgery for ruptured cerebral aneurysm.