J 2021

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

SOLÁR, Peter, Zdeněk MACKERLE, Marek JOUKAL and Radim JANČÁLEK

Basic information

Original name

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

Authors

SOLÁR, Peter (703 Slovakia, belonging to the institution), Zdeněk MACKERLE (203 Czech Republic, belonging to the institution), Marek JOUKAL (203 Czech Republic, belonging to the institution) and Radim JANČÁLEK (203 Czech Republic, guarantor, belonging to the institution)

Edition

NEUROSURGICAL REVIEW, NEW YORK, SPRINGER, 2021, 0344-5607

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30103 Neurosciences

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.800

RIV identification code

RIV/00216224:14110/21:00120663

Organization unit

Faculty of Medicine

UT WoS

000517727800002

Keywords in English

Aneurysmal subarachnoid hemorrhage; Non-steroidal anti-inflammatory drugs; Vasospasms; Cerebral ischemia

Tags

International impact, Reviewed
Změněno: 7/6/2021 14:13, Mgr. Tereza Miškechová

Abstract

V originále

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.