SUCCESSFUL PREVENTION OF NEUROLOGICAL DEFICIT IN SAH PATIENTS WITH 2-CHLORODEOXYADENOSINE

Twenty patients suffering from subarachnoid haemorrhage due to rupture d intracranial aneurysm and operated on within 72 h after SAH were tre ated with an experimental immunosuppressive drug 2-chlorodeoxyadenosin e (2-CDA), dose 0.05 mg/kg/day i.v. for 7 days. The 2-CDA treatment wa s started immediately after angiographic confirmation of ruptured aneu rysm, and the standard pharmacological treatment (nimodipine and stero ids) was also given. 50% of patients were severely threatened by ''del ayed vasospasm'' or late neurological deficit (Fisher's score 3 or 4). The neurological outcome (assessed 8-12 weeks after SAH) was good (GO S = 1) in 70%, and fair (moderate disability, GOS = 2) in 25%. A singl e case of severe disability (GOS = 3), as well as two cases of less th an perfect outcome (GOS = 2), were related to unusual pre- or intraope rative complications. We conclude that the low doses of 2-CDA can be c onsidered as a valuable adjunct to the standard pharmacotherapy of SAH patients operated on early.