title: Pharmacological agents in aneurysmal subarachnoid hemorrhage: successes and failures.
abstract: BACKGROUND
  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 following medications: calcium channel 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.
authors.affiliation: Division of Cerebrovascular Diseases and Neurosciences Critical Care, Department of Neurology, The Ohio State University College of Medicine, Columbus, OH.
authors.forename: Réza
authors.initials: R
authors.lastname: Behrouz
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sadat-Hosseiny
mesh_terms: D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D001241:Aspirin