Supplementary Table 2: Meta-analyses of subarachnoid haemorrhage trials

Reference / Treatment / Number of trials / Total number of patients / Results
Feigin et al. (2005)4 / Corticosteroids / 3 / 256 / Too few patients treated with hydrocortisone or fludrocortisone to draw any definitive conclusions
Dorhout-Mees et al. (2007)3 / Antiplatelet drugs (aspirin, ticlopidine, dipyridamole, OKY-046) / 7 / 1,385 / No effect of antiplatelet drugs on poor outcome, secondary brain ischaemia or intracranial hemorrhage, ticlopidine significantly reduced poor outcome
Dorhout-Mees et al. (2007)2 / Calcium channel antagonists (magnesium, nimodipine, nicardipine, AT877) / 16 / 3,361 / Included three studies of magnesium, overall calcium channel antagonists reduced poor outcome, oral nimodipine alone also improved outcome, whereas other calcium channel antagonists or intravenous nimodipine did not. Overall analysis also showed that they reduced secondary ischaemia
Dankbaar et al. (2010)1 / Haemodynamic therapy / 11 / ND / Haemodilution did not improve cerebral blood flow, one uncontrolled study found that hypervolaemia increased cerebral blood flow and some studies of hypertension or a combination of haemodilution, hypervolaemia and haemodilution increased cerebral blood flow, but overall there was no good evidence from controlled studies for a positive effect of haemodynamic manouevres on cerebral blood flow, let alone clinical outcome
Vergouwen et al. (2010)10 / 3-hydroxy-3-methylglutaryl-coenzyme A / 4 / 190 / No signficant effect on transcranial Doppler flow velocities, delayed cerebral ischaemia, poor outcome or mortality
Zhang et al. (2010)11 / Tirilazad / 5 / 3,821 / No effect of tirilazad on death or poor outcome, although the drug was associated with less delayed cerebral ischaemia
Kramer et al. (2011)7 / Fibrinolytics (urokinase, recombinant tissue plasminogen activator) / 5 / 465 / Fibrinolytic drugs significantly reduced poor outcome, delayed neurological deficits, angiographic vasospasm and hydrocephalus
Liu et al. (2011)8 / Fasudil / 8 / 843 / Fasudil significantly reduced angiographic vasospasm, symptomatic vasospasm and cerebral infarction and improved clinical outcome
Liu et al. (2011)9 / Nimodipine / 8 / 1,514 / Nimodipine improved outcome and reduced mortality, symptomatic vasospasm, delayed neurological deficit and cerebral infarction
Guo et al. (2012)6 / Endothelin receptor antagonists / 4 / 2,024 / Endothelin receptor antagonists reduced angiographic vasospasm and delayed ischaemic neurological deficits but had no effect on unfavourable outcome or death
Golan et al. (2013)5 / Magnesium / 13 / 2,401 / Magnesium reduced delayed cerebral ischaemia but did not improve neurological outcome or decrease cerebral infarction, radiographic vasospasm or mortality

Abbreviation: ND, not determined.

1. Dankbaar, J. W., Slooter, A. J., Rinkel, G. J. & van der Schaaf, I. C. Effect of different components of triple-H therapy on cerebral perfusion in patients with aneurysmal subarachnoid haemorrhage: a systematic review. Crit Care 14, R23 (2010)

2. Dorhout Mees, S. M., et al. Calcium antagonists for aneurysmal subarachnoid haemorrhage. Cochrane. Database. Syst. Rev. CD000277 (2007)

3. Dorhout Mees, S. M., van den Bergh, W. M., Algra, A. & Rinkel, G. J. Antiplatelet therapy for aneurysmal subarachnoid haemorrhage. Cochrane. Database. Syst. Rev. CD006184 (2007)

4. Feigin, V. L., et al. Corticosteroids for aneurysmal subarachnoid haemorrhage and primary intracerebral haemorrhage. Cochrane. Database. Syst. Rev. CD004583 (2005)

5. Golan, E., Vasquez, D. N., Ferguson, N. D., Adhikari, N. K. & Scales, D. C. Prophylactic magnesium for improving neurologic outcome after aneurysmal subarachnoid hemorrhage: systematic review and meta-analysis. J. Crit Care 28, 173-181 (2013)

6. Guo, J., Shi, Z., Yang, K., Tian, J. H. & Jiang, L. Endothelin receptor antagonists for subarachnoid hemorrhage. Cochrane. Database. Syst. Rev. 9, CD008354 (2012)

7. Kramer, A. H. & Fletcher, J. J. Locally-administered intrathecal thrombolytics following aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Neurocrit. Care 14, 489-499 (2011)

8. Liu, G. J., et al. Systematic assessment and meta-analysis of the efficacy and safety of fasudil in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage. Eur. J. Clin. Pharmacol. (2011)

9. Liu, X. & Rinkel, G. J. Aneurysmal and clinical characteristics as risk factors for intracerebral haematoma from aneurysmal rupture. J. Neurol. 258, 862-865 (2011)

10. Vergouwen, M. D., de Haan, R. J., Vermeulen, M. & Roos, Y. B. Effect of statin treatment on vasospasm, delayed cerebral ischemia, and functional outcome in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis update. 41, e47-e52 (2010)

11. Zhang, S., Wang, L., Liu, M. & Wu, B. Tirilazad for aneurysmal subarachnoid haemorrhage. Cochrane. Database. Syst. Rev. 2, CD006778 (2010)