Is Aspirin a Worthy Candidate in Preventing Intracranial Aneurysm Rupture?

Subarachnoid hemorrhage (SAH) usually occurs with a thunderclap headache or the worst headache of a patient's life, leading to a neurologic emergency. Among cases of nontraumatic SAH, 80%–85% are caused by ruptured intracranial aneurysms (IAs) and comprise 3% of all strokes in high-income countries In the years 2000–2008, the incidence of SAH was 4–7 per 100,000 person-years in high-income and low-to middle-income countries. Outcome after aneurysmal SAH depends on several factors, including severity of the initial hemorrhage, rebleeding, perioperative medical management, and timing and technical success for vascular malformation exclusion from the cerebral circulation. It has been estimated that 30% of patients affected by aneurysmal SAH die within 48 hours of admission, whereas up to 76% die by day 14 following hospitalization.Moreover, SAH could lead to important neurologic sequelae that decrease quality of life in nearly one third of survivors. Despite advances in diagnostic, anesthetic, and intraoperative neurosurgical techniques6 as well as preoperative and postoperative management, the ultimate overall outcome in patients with aneurysmal SAH remains unsatisfactory.