Effect of a free radical scavenger, edaravone, in the treatment of patients with aneurysmal subarachnoid hemorrhage

Neurosurgery. 2009 Mar;64(3):423-8; discussion 428-9. doi: 10.1227/01.NEU.0000338067.83059.EB.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antipyrine / analogs & derivatives*
  • Antipyrine / therapeutic use
  • Cerebral Infarction / epidemiology*
  • Cerebral Infarction / prevention & control
  • Comorbidity
  • Edaravone
  • Female
  • Free Radical Scavengers / therapeutic use
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Risk Assessment / methods*
  • Risk Factors
  • Subarachnoid Hemorrhage / drug therapy*
  • Treatment Outcome
  • Vasospasm, Intracranial / epidemiology*
  • Vasospasm, Intracranial / prevention & control

Substances

  • Free Radical Scavengers
  • Edaravone
  • Antipyrine