Investigational drugs for vasospasm after subarachnoid hemorrhage

Roberta T. Tallarico, Michael A. Pizzi, William D. Freeman

Research output: Contribution to journalReview article

6 Scopus citations

Abstract

Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) represents 3% of all strokes in the US. When the patient survives it can lead to permanent incapacity especially if the patient develops vasospasm. The vasospasm is a multifactorial disorder and can lead to delayed cerebral ischemia (DCI). Most of the drugs tested to treat vasospasm failed to improve outcome and the only exception is nimodipine. Areas covered: In this review, the authors describe the multifactorial process of vasospasm leading DCI after aSAH, discussing the treatments available based on the past and latest researches. Expert opinion: Nimodipine is the only FDA-approved medication with neuroprotective effect and able to improve outcomes after aSAH. Understanding nimodipine trials is mandatory to understand and criticize all the drug trials published until now. The mechanism to vasospasm is multifactorial and not completely understood and all the other attempts to find a better medication could not prove superior results. Newton and PEGylated Carboxyhemoglobin Bovine can be potentially effective to prevent vasospasm but we still need more data and large studies. Future research should investigate newer drugs, as well as the combination of multiple drugs therapy and the association with blood evacuation techniques.

Original languageEnglish (US)
Pages (from-to)313-324
Number of pages12
JournalExpert Opinion on Investigational Drugs
Volume27
Issue number4
DOIs
StatePublished - Apr 3 2018

Keywords

  • Delayed cerebral ischemia
  • nimodipine
  • subarachnoid hemorrhage
  • vasospasm

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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