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(Stroke. 1999;30:1983-1990.)
© 1999 American Heart Association, Inc.

Abstracts of Literature

Abstracts of Literature

Askiel Bruno Engin Y. Yilmaz

	Cerebral Aneurysms

 
AB-14455-99
Double-Blind, Randomized, Vehicle-Controlled Study of High-Dose Tirilazad Mesylate in Women With Aneurysmal Subarachnoid Hemorrhage, Part I: A Cooperative Study in Europe, Australia, New Zealand, and South Africa—Lanzino G (Dept of Neurosurgery, Box 212, Univ of Virginia Health Sciences Center, Charlottesville, VA 22908), Kassell NF, Dorsch NWC, Pasqualin A, Brandt L, Schmiedek P, Truskowski LL, Alves WM, and the Participants—J Neurosurg. 1999;90:1011–1017.

Object. Findings from previous multicenter clinical trials have suggested that tirilazad mesylate, a synthetic nonhormonal 21-aminosteroid, might be effective in preventing delayed cerebral ischemia following subarachnoid hemorrhage (SAH). This beneficial effect, however, was greater in males than females, possibly because of gender-related pharmacokinetic differences. The authors sought to assess the effects of administering a larger dose of tirilazad in women with SAH.

Methods. To test the efficacy of a higher tirilazad mesylate dose in female patients, a prospective randomized, double-blind, vehicle-controlled trial was conducted at 56 neurosurgical centers in Europe, Australia, New Zealand, and South Africa. Eight hundred nineteen patients were randomly assigned to receive either 15 mg/kg/day of tirilazad mesylate or a placebo containing the citrate vehicle. The two groups were similar in prognostic factors for delayed cerebral ischemia and overall outcome. High-dose tirilazad appeared to be well tolerated because no differences in the incidence of untoward medical events were noted between the two groups. Medical and surgical interventions were no different in the two treatment groups except for hyperdynamic therapy (intentional hypervolemia, induced hypertension, and/or hemodilution), which was more often used in the placebo-treated group to . . . [Full Text of this Article]