Effect of a free radical scavenger, edaravone, in the treatment of patients with aneurysmal subarachnoid hemorrhage.
OBJECTIVE
It is hypothesized that cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is induced by free radicals released from a subarachnoid clot. This study therefore investigated the effect of a new free radical scavenger, edaravone, in the treatment of patients with aneurysmal SAH.


METHODS
Ninety-one patients with aneurysmal SAH participated in this study and were randomized into a control group (n = 42) and an edaravone-treated group (n = 49). The difference between the 2 groups in terms of incidence of delayed ischemic neurological deficits (DINDs) and cerebral infarction caused by vasospasm, and Glasgow Outcome Scale score at 3 months after SAH were statistically analyzed.


RESULTS
The incidence of DINDs was 21% in the control group and 10% in the edaravone-treated group, yet there was no statistically significant difference between the 2 groups (P = 0.118). In patients with DINDs, the incidence of cerebral infarction caused by vasospasm was 66% in the control group and 0% in the edaravone-treated group (P = 0.028), whereas the incidence of poor outcome caused by vasospasm was 71% in the control group and 0% in the edaravone-treated group (P = 0.046).


CONCLUSIONS
We found a trend toward a lesser incidence of DINDs and a lesser incidence of poor outcome caused by cerebral vasospasm in edaravone-treated patients. It might therefore be suggested that edaravone is a useful agent for the treatment of aneurysmal SAH.
Munakata
Akira
A
Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Japan.
Ohkuma
Hiroki
H
Nakano
Takahiro
T
Shimamura
Norihito
N
Asano
Kenichirou
K
Naraoka
Masato
M
D000983:Antipyrine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity; D000077553:Edaravone; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy*; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000453:epidemiology* / Q000517:prevention & control
D016166:Free Radical Scavengers; D000077553:Edaravone; D000983:Antipyrine