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Neurosurgery:
doi: 10.1227/01.NEU.0000338067.83059.EB
Clinical Studies

EFFECT OF A FREE RADICAL SCAVENGER, EDARAVONE, IN THE TREATMENT OF PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE

Munakata, Akira M.D.; Ohkuma, Hiroki M.D.; Nakano, Takahiro M.D.; Shimamura, Norihito M.D.; Asano, Kenichirou M.D.; Naraoka, Masato M.D.

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Abstract

OBJECTIVE: It is hypothesized that cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is induced by free radicals released from a subarachnoid clot. This study therefore investigated the effect of a new free radical scavenger, edaravone, in the treatment of patients with aneurysmal SAH.

METHODS: Ninety-one patients with aneurysmal SAH participated in this study and were randomized into a control group (n = 42) and an edaravone-treated group (n = 49). The difference between the 2 groups in terms of incidence of delayed ischemic neurological deficits (DINDs) and cerebral infarction caused by vasospasm, and Glasgow Outcome Scale score at 3 months after SAH were statistically analyzed.

RESULTS: The incidence of DINDs was 21% in the control group and 10% in the edaravone-treated group, yet there was no statistically significant difference between the 2 groups (P = 0.118). In patients with DINDs, the incidence of cerebral infarction caused by vasospasm was 66% in the control group and 0% in the edaravone-treated group (P = 0.028), whereas the incidence of poor outcome caused by vasospasm was 71% in the control group and 0% in the edaravone-treated group (P = 0.046).

CONCLUSION: We found a trend toward a lesser incidence of DINDs and a lesser incidence of poor outcome caused by cerebral vasospasm in edaravone-treated patients. It might therefore be suggested that edaravone is a useful agent for the treatment of aneurysmal SAH.

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