Aspirin and Aneurysmal Subarachnoid Hemorrhage

Gross, Bradley A.; Lai, Pui Man Rosalind; Frerichs, Kai U.; Du, Rose

doi:10.1016/j.wneu.2013.03.072

Cited by 81 publications

(63 citation statements)

References 11 publications

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“…For instance, a few studies failed to reveal any significant impact of pre-hemorrhage aspirin use on outcome after aneurysmal SAH. 8,9 In the present study, the influence of antiplatelet agents was found to differ among age groups. This is the first study to report that pre-hemorrhage antiplatelet use significantly improved prognosis, albeit only in younger patients (,60 years).…”

Section: Discussionmentioning

confidence: 43%

“…In previous studies, the trend toward reduced risk of SAH was particularly pronounced in patients receiving aspirin. [6][7][8] The underlying mechanisms associated with reduced risk were attributed to a possible inhibitory effect of aspirin on the inflammatory cascade implicated in intracranial aneurismal formation 11 -the cause of SAH in approximately 85% of cases. 12 These data suggested that aspirin may potentially be used as therapeutic agent to prevent intracranial aneurysm growth and rupture.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with younger age groups, older age groups have different stroke risk profiles and clinical features, but only a few studies on SAH have compared different age groups. 4,5 Furthermore, the influence of antiplatelet drugs before onset of SAH has not been clearly determined-some studies have indicated that aspirin protected brain from cerebral aneurysm rupture, [6][7][8] whereas another showed it increased rebleeding rates. 9 The aim of the present study was to examine the risk factor profiles and functional outcomes of SAH among different age groups using the Japan Standard Stroke From the *Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama; and †Department of Neurology, Shimane University, Shimane, Japan.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Influence of Antiplatelet Drugs on the Outcome of Subarachnoid Hemorrhage Differs with Age

Kato

Hayashi

Tanahashi

et al. 2015

Journal of Stroke and Cerebrovascular Diseases

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of Antiplatelet Drugs on the Outcome of Subarachnoid Hemorrhage Differs with Age

Kato

Hayashi

Tanahashi

et al. 2015

Journal of Stroke and Cerebrovascular Diseases

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“…116 Other interventions, such as the use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) and calcium channel blockers, may retard aneurysm formation through the inhibition of nuclear factor-κB and other pathways, but observational findings are not supportive of the use of statins for prevention.…”

Section: August 2015mentioning

confidence: 99%

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Thompson¹,

Brown²,

Amin‐Hanjani³

et al. 2015

Stroke

799

352

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Purpose— The aim of this updated statement is to provide comprehensive and evidence-based recommendations for management of patients with unruptured intracranial aneurysms. Methods— Writing group members used systematic literature reviews from January 1977 up to June 2014. They also reviewed contemporary published evidence-based guidelines, personal files, and published expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulated recommendations using standard American Heart Association criteria. The guideline underwent extensive peer review, including review by the Stroke Council Leadership and Stroke Scientific Statement Oversight Committees, before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. Results— Evidence-based guidelines are presented for the care of patients presenting with unruptured intracranial aneurysms. The guidelines address presentation, natural history, epidemiology, risk factors, screening, diagnosis, imaging and outcomes from surgical and endovascular treatment.

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“…Recent studies have demonstrated that aspirin, which inhibits cyclooxygenase (COX) and affects anti-aggregating effect, decreases the incidence of aneurysmal subarachnoid hemorrhage by counteracting proinflammatory pathways and stabilizing aneurysmal walls [4, 5]. Cilostazol is the type III phosphodiesterase inhibitor that has recently focused on intimal protection through the anti-inflammatory effect and anti-atherogenic effect by increasing endothelial nitric oxide synthase as well as the platelet anti-aggregating effect.…”

Section: Introductionmentioning

confidence: 99%

Prevention Effect of Antiplatelets on Aneurysm Rupture in a Mouse Intracranial Aneurysm Model

et al. 2018

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Background and Purpose: Subarachnoid hemorrhage (SAH) from intracranial aneurysm rupture results in significant morbidity and mortality. In the present study, we examined the effect of most widely used antiplatelet drugs, aspirin and cilostazol, on aneurysm rupture prevention using a mouse intracranial aneurysm model. Materials and Methods: Intracranial aneurysms were induced by a combination of deoxycorticosterone acetate-salt and a single injection of elastase into the cerebrospinal fluid in mice. Treatment with aspirin or cilostazol was started 1 day after aneurysm induction. Aneurysm rupture was detected by neurological symptoms and the presence of intracranial aneurysm with SAH was confirmed by post-mortem examination. Results: Aspirin (10 mg/kg) significantly reduced aneurysm rupture (control:aspirin = 80%:31%, p < 0.05) without affecting the overall incidence of aneurysm formation (60%:62%). Cilostazol (3 mg/kg, 30 mg/kg) did not reduce both rupture rate (control:3 mg/kg:30 mg/kg = 81%:67%:77%) and the overall incidence of aneurysm formation (control:3 mg/kg:30 mg/kg = 72%:71%:76%). Tail vein bleeding time prolonged significantly in both aspirin and cilostazol groups (p < 0.01). Conclusion: Aspirin prevented aneurysm rupture in a mouse intracranial aneurysm model, while cilostazol did not. Aspirin, the most frequently used drug for patients with ischemic myocardial and cerebral diseases, is also effective in preventing cerebral aneurysmal rupture.

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Aspirin and Aneurysmal Subarachnoid Hemorrhage

Cited by 81 publications

References 11 publications

Influence of Antiplatelet Drugs on the Outcome of Subarachnoid Hemorrhage Differs with Age

Influence of Antiplatelet Drugs on the Outcome of Subarachnoid Hemorrhage Differs with Age

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Prevention Effect of Antiplatelets on Aneurysm Rupture in a Mouse Intracranial Aneurysm Model

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