Aneurysmal subarachnoid hemorrhage (aSAH) remains a significant cause of stroke disability despite gradual reductions in physical morbidity and mortality. Heparin is an effective anti-inflammatory agent and may potentially prevent delayed neurological injury in the days to weeks after the hemorrhage. Various human studies have shown the safety of a continuous infusion of low-dose unfractionated heparin in the setting of subarachnoid hemorrhage as well as its efficacy in minimizing delayed neurological deficits including symptomatic cerebral vasospasm, vasospasm-related infarction, and cognitive dysfunction. Studies have also shown mixed results with low-molecular-weight heparin usage in this patient population. Heparin treatment is not associated with significant hemorrhagic complications; however, vigilance is essential for early detection of heparin-induced thrombocytopenia in order to prevent devastating sequelae. Multicenter randomized controlled trials are necessary for objective characterization of the effects of heparin.
CITATION STYLE
Khattar, N. K., Bak, E., White, A. C., & James, R. F. (2020). Heparin treatment in aneurysmal subarachnoid hemorrhage: A review of human studies. In Acta Neurochirurgica, Supplementum (Vol. 127, pp. 15–19). Springer-Verlag Wien. https://doi.org/10.1007/978-3-030-04615-6_3
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