Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition associated with the development of early brain injury (EBI) and delayed cerebral ischemia (DCI). Pharmacological treatment of vasospasm following aSAH currently mainly comprises nimodipine administration. In the past few years, many drugs that can potentially benefit cases of subarachnoid hemorrhage have become available. The objective of this review is to critically assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) following aSAH. A systematic literature review was conducted following PRISMA guidelines. The search was aimed at studies addressing aSAH and NSAIDs during the 2010 to 2019 period, and it yielded 13 articles. Following the application of search criteria, they were divided into two groups, one containing 6 clinical articles and the other containing 7 experimental articles on animal models of aSAH. Inflammatory cerebral changes after aneurysm rupture contribute to the development of EBI, DCI and cerebral vasospasm. It appears that NSAIDs (especially coxibs) are even more effective in reducing vasospasm than nimodipine. Other beneficial effects of NSAIDs include reduction in mortality, improved functional outcome and increased hypoaggregability. However, despite these positive effects, there is only one randomized, double-blind, placebo-controlled trial showing a tendency towards a better outcome with lower incidence of vasospasm or mortality in patients following aSAH.

中文翻译：

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非类固醇消炎药在蛛网膜下腔出血后血管痉挛和延迟性脑缺血的病理生理中的作用：一项重要的综述。

动脉瘤性蛛网膜下腔出血（aSAH）是与早期脑损伤（EBI）和延迟性脑缺血（DCI）的发展相关的威胁生命的疾病。aSAH后血管痉挛的药理治疗目前主要包括尼莫地平给药。在过去的几年中，已经出现了许多可能有益于蛛网膜下腔出血病例的药物。这篇综述的目的是严格评估aSAH后非甾体类抗炎药（NSAIDs）的作用。按照PRISMA指南进行系统的文献综述。该搜索的目的是针对2010年至2019年期间针对aSAH和NSAID的研究，共检索到13篇文章。应用搜索条件后，他们分为两组，一篇包含6篇临床文章，另一篇包含7篇关于aSAH动物模型的实验文章。动脉瘤破裂后的炎症性脑变化有助于EBI，DCI和脑血管痉挛的发展。看来，NSAID（尤其是coxibs）在减轻血管痉挛方面比尼莫地平更有效。非甾体抗炎药的其他有益作用包括降低死亡率，改善功能结局和增加抗凝性。然而，尽管有这些积极的作用，但只有一项随机，双盲，安慰剂对照试验显示，aSAH患者的预后趋于更好，血管痉挛或死亡率降低。DCI和脑血管痉挛。看来，NSAID（尤其是coxibs）在减轻血管痉挛方面比尼莫地平更有效。非甾体抗炎药的其他有益作用包括降低死亡率，改善功能结局和增加抗凝性。然而，尽管有这些积极的作用，但只有一项随机，双盲，安慰剂对照试验显示，aSAH患者的预后趋于更好，血管痉挛或死亡率降低。DCI和脑血管痉挛。看来，NSAID（尤其是coxibs）在减轻血管痉挛方面比尼莫地平更有效。非甾体抗炎药的其他有益作用包括降低死亡率，改善功能结局和增加抗凝性。然而，尽管有这些积极的作用，但只有一项随机，双盲，安慰剂对照试验显示，aSAH患者的预后趋于更好，血管痉挛或死亡率降低。