Non-steroidal anti-inflammatory drugs in the pathophysiology of vasospasms and delayed cerebral ischemia following subarachnoid hemorrhage: a critical review.


Journal

Neurosurgical review
ISSN: 1437-2320
Titre abrégé: Neurosurg Rev
Pays: Germany
ID NLM: 7908181

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 28 11 2019
accepted: 19 02 2020
revised: 03 02 2020
pubmed: 4 3 2020
medline: 16 6 2021
entrez: 4 3 2020
Statut: ppublish

Résumé

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition associated with the development of early brain injury (EBI) and delayed cerebral ischemia (DCI). Pharmacological treatment of vasospasm following aSAH currently mainly comprises nimodipine administration. In the past few years, many drugs that can potentially benefit cases of subarachnoid hemorrhage have become available. The objective of this review is to critically assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) following aSAH. A systematic literature review was conducted following PRISMA guidelines. The search was aimed at studies addressing aSAH and NSAIDs during the 2010 to 2019 period, and it yielded 13 articles. Following the application of search criteria, they were divided into two groups, one containing 6 clinical articles and the other containing 7 experimental articles on animal models of aSAH. Inflammatory cerebral changes after aneurysm rupture contribute to the development of EBI, DCI and cerebral vasospasm. It appears that NSAIDs (especially coxibs) are even more effective in reducing vasospasm than nimodipine. Other beneficial effects of NSAIDs include reduction in mortality, improved functional outcome and increased hypoaggregability. However, despite these positive effects, there is only one randomized, double-blind, placebo-controlled trial showing a tendency towards a better outcome with lower incidence of vasospasm or mortality in patients following aSAH.

Identifiants

pubmed: 32124117
doi: 10.1007/s10143-020-01276-5
pii: 10.1007/s10143-020-01276-5
doi:

Substances chimiques

Anti-Inflammatory Agents, Non-Steroidal 0
Nimodipine 57WA9QZ5WH

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

649-658

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Auteurs

Peter Solar (P)

Department of Neurosurgery - St. Anne's University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
Department of Neurosurgery, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic.
Cellular and Molecular Neurobiology Research Group, Department of Anatomy, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Zdenek Mackerle (Z)

Department of Neurosurgery - St. Anne's University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic.
Department of Neurosurgery, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic.

Marek Joukal (M)

Cellular and Molecular Neurobiology Research Group, Department of Anatomy, Faculty of Medicine, Masaryk University, Brno, Czech Republic.

Radim Jancalek (R)

Department of Neurosurgery - St. Anne's University Hospital Brno, Faculty of Medicine, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic. radim.jancalek@fnusa.cz.
Department of Neurosurgery, St. Anne's University Hospital Brno, Pekarska 53, 656 91, Brno, Czech Republic. radim.jancalek@fnusa.cz.

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