Why the study?
Does cilostazol prevent cerebral vasospasm and ischemic lesions in patients treated surgically for subarachnoid hemorrhage?
Does cilostazol prevent cerebral vasospasm and ischemic lesions in patients treated surgically for subarachnoid hemorrhage?
Cilostazol administration may reduce the incidence of severe cerebral vasospasm and subsequent cerebral infarction following surgical treatment for subarachnoid hemorrhage.
Cilostazol was associated with fewer vasospasm events after SAH surgery; hypothesis-generating and requires RCT confirmation before practice change.
Cilostazol is an antiplatelet aggregation inhibitor drug associated with increased cerebral blood flow and inflammation suppression. This study evaluated administration of cilostazol to prevent cerebral vasospasm following subarachnoid hemorrhage (SAH) in 50 patients treated surgically from December 2004 to November 2006. All patients, excluding those with Hunt and Kosnik grade 5 or who had undergone late surgery, were classified into two groups: 26 patients who received 200 mg/day cilostazol from postoperative day 1 to day 14 and 24 control patients. The frequency and the degree of cerebral vasospasm, occurrence of ischemic lesion, and clinical symptoms due to vasospasm were compared between the two groups. The appearance of severe vasospasm on angiography, persistent symptomatic spasm, and new cerebral infarction due to vasospasm demonstrated by neuroimaging were apparently lower in the cilostazol group than in the control group, suggesting that cilostazol may significantly suppress cerebral vasospasm following SAH.
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Yoshimoto et al. (2009) studied this question.
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