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Therapeutic small molecules in the development of treatment for subarachnoid hemorrhage

Siddharth Shah1* ,  Abiy Tereda2 ,  Brandon Lucke-Wold1 ,  Pavel S. Pichardo-Rojas3
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1 Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
2 Department of Neurosurgery, Georgetown American University, George Town, Guyana
3 The Vivian L. Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA
INNOSC Theranostics and Pharmacological Sciences, 2019 https://doi.org/10.36922/itps.2019
Submitted: 12 October 2023 | Accepted: 7 November 2023 | Published: 11 January 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Subarachnoid hemorrhage (SAH) is a severe and often fatal condition characterized by the accumulation of blood beneath the arachnoid layer of the meninges. Predominantly affecting individuals in the 40–60 age range, it is commonly caused by head trauma from falls or car accidents. Ruptures of cerebral aneurysms also contribute significantly to SAH. Risk factors for SAH include hypertension and smoking, and symptoms typically include severe headache and neck pain. Diagnosing SAH typically involves a combination of medical history, physical examination, and imaging studies such as computed tomography angiography or magnetic resonance imaging angiography. Recent research suggests that pharmaceutical management of intracerebral hemorrhage (ICH) includes the administration of recombinant activated factor VII, tranexamic acid, and aggressive blood pressure reduction. For patients with significant SAH and ICH, minimally invasive surgical procedures for hematoma evacuation, as well as surgical evacuation of SAH and ICH, have proven to be highly beneficial. Furthermore, an emerging area of treatment involves therapeutic small molecules designed to interrupt the pathophysiological pathways leading to SAH. This novel approach holds promise for advancing our understanding and management of this complex medical condition.

Keywords
Subarachnoid hemorrhage
Neurosurgery
Therapeutic small molecules
Novel therapy
Pharmacological management
Funding
None.
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The authors declare that they have no competing interests.
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