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Updated: May 12, 2026
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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Aspirin and aneurysmal subarachnoid hemorrhage
Bradley A Gross1, Pui Man Rosalind Lai1, Kai U Frerichs1
1Department of Neurological Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
World Neurosurgery
|April 4, 2013
Summary
Aspirin use in patients with cerebral aneurysms was associated with a lower rate of hemorrhagic presentation. Importantly, aspirin did not negatively affect clinical outcomes or increase complications in patients with aneurysmal subarachnoid hemorrhage (SAH).
Area of Science:
- Neurosurgery
- Neurology
- Clinical Pharmacology
Background:
- Aspirin's potential benefits in reducing aneurysm rupture risk are debated.
- Concerns exist regarding aspirin's antiplatelet effects in acute aneurysmal subarachnoid hemorrhage (SAH).
- Balancing aspirin's risks and benefits is crucial for patient management.
Purpose of the Study:
- To evaluate the impact of pre-presentation aspirin use on outcomes in patients with cerebral aneurysms.
- To assess whether aspirin influences hemorrhagic presentation, clinical/radiographic grades, vasospasm, or long-term outcomes in aneurysmal SAH.
Main Methods:
- Retrospective review of 747 consecutive patients with cerebral aneurysms.
- Comparison of demographics, aneurysm characteristics, clinical/radiographic severity, vasospasm, and 1-year outcomes.
- Analysis between patients on aspirin at presentation versus those not taking aspirin.
Main Results:
- Patients on aspirin showed a significantly lower rate of hemorrhagic presentation (28% vs. 40%).
- No significant differences in presenting clinical (Hunt and Hess) or radiographic (Fisher) grades were observed.
- Aspirin use was not associated with increased vasospasm, delayed cerebral ischemia, or poor 1-year outcomes.
Conclusions:
- Pre-presentation aspirin use in cerebral aneurysm patients is linked to a reduced risk of hemorrhagic presentation.
- Aspirin does not appear to worsen clinical or radiographic severity, vasospasm, or patient outcomes in aneurysmal SAH.
- Findings suggest aspirin may be safely continued in patients presenting with aneurysmal SAH.
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