Pharmacological agents in aneurysmal subarachnoid hemorrhage: Successes and failures

Reza Behrouz, Zahra Sadat-Hosseiny

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating condition with high mortality. Proper management of this complex disease requires early surgical intervention followed by medical therapy. Pharmacological agents that unequivocally improve outcomes in aSAH are scarce. Methods: The authors performed an exhaustive query of several databases including MEDLINE, the CENTRAL Register of Controlled Trials, and the Cochrane Database of Systematic Reviews for specific evidence on key medications that have been used in the treatment of aSAH. Results: The bulk of the data available pertained to the followingmedications: calciumchannel blockers, magnesium, statins, antifibrinolytics, aspirin, glucocorticoids, clazosentan, and tirilazad. Except for calcium channel blockers, the authors could not find any hard evidence that any of these agents affected outcome to a tangible degree. Aspirin may have some promise in prevention of aneurysm rupture and incidence of aSAH, but more substantive data are needed to conclusively corroborate this. Conclusions: Investigational efforts to attain outcome-modifying agents have had dubious results, but the inquest for discovery should not discontinue.

Original languageEnglish (US)
Pages (from-to)104-108
Number of pages5
JournalClinical Neuropharmacology
Volume38
Issue number3
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Keywords

  • aminocaproic acid
  • aspirin
  • clazosentan
  • magnesium
  • medical therapy
  • statins
  • subarachnoid hemorrhage
  • tirilazad
  • tranexamic acid

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

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