Condition

Subarachnoid hemorrhage

Clinical trials and treatment information for Subarachnoid hemorrhage

7.9M
People Affected
150
Active Trials
393K
New Cases/Year
353K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Ventricular Drainage (EVD)
90% Effectiveness• 88% Confidence• 52% Safety• 16 trials• 5K participants
HIGH EvidenceExcellent ValueDose: N/A (procedure)
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Comparative Safety Scale(Higher is safer)

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52
DangerousModerateSafe

Time to Effect

Immediate

Duration

Days to weeks

Response Rate

95%

Remission Rate

%

Number Needed to Treat (NNT)

2

Number Needed to Harm (NNH)

15

Common Side Effects:

Infection (ventriculitis/meningitis): 10%
Hemorrhage (catheter-related): 3%
Catheter malfunction/occlusion: 7%
Over-drainage/subdural hematoma: 3%

Annual Cost of Care

Drug Cost

$0

Monitoring

$1,000

Side Effects

$1,000

Total Annual

$2,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.6

Cost per Responder

$21,053

Treatment Outcomes
Primary Outcomes
Intracranial Pressure (ICP)25 mmHg
-40% (-10 mmHg)
Glasgow Coma Scale (GCS) ScoreGCS score: 9/15
+44.4% (+4 points)
Ventricular Size (Evans Index)Evans Index: 0.35
-14.3% (-0.05 units)
Risk of Permanent CSF Shunt60% risk
-50% (-30% absolute risk reduction)
Secondary Benefits
Modified Rankin Scale (mRS) Score at 3 monthsmRS score: 4/6
-50% (-2 points)
Length of ICU Stay14 days
-28.6% (-4 days)
Incidence of Symptomatic Vasospasm30% incidence
-33.3% (-10% absolute reduction in incidence)
Common Side Effects
Infection (ventriculitis/meningitis)
+10%
Hemorrhage (catheter-related)
+3%
Catheter malfunction/occlusion
+7%
2
Endovascular Coiling
88% Effectiveness• 90% Confidence• 50% Safety• 17 trials• 20K participants
HIGH EvidenceExcellent ValueDose: N/A (procedure)
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Comparative Safety Scale(Higher is safer)

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50
DangerousModerateSafe

Time to Effect

Immediate

Duration

One-time procedure

Response Rate

90%

Remission Rate

%

Number Needed to Treat (NNT)

14

Common Side Effects:

Procedure-related stroke/TIA: 7%
Aneurysm perforation/rupture during procedure: 2%
Thromboembolic complications: 7%
Groin hematoma/complications: 10%
Coil compaction/recurrence (requiring re-treatment): 15%

Annual Cost of Care

Drug Cost

$200

Monitoring

$3,000

Side Effects

$1,000

Total Annual

$4,200

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.8

Treatment Outcomes
Primary Outcomes
Death or Dependency (mRS > 2) at 1 yearExpected 30% for SAH
-25% (-7.5 percentage points)
Reduction in 1-Year Rebleeding RiskExpected annual rebleeding risk for untreated/high-risk ruptured aneurysm: 10%
-90% (-9 percentage points)
Modified Rankin Scale (mRS) Score at 6 monthsmRS score: 3.0
-26.7% (-0.8 points)
Secondary Benefits
EQ-5D Utility Score0.65 units
+15.4% (+0.10 units)
Incidence of Post-Procedure Seizures (1 year)Expected 10% (post-SAH with surgical clipping)
-70% (-7 percentage points)
Length of Hospital Stay14 days (typical for SAH with open surgery)
-28.6% (-4 days)
Common Side Effects
Procedure-related stroke/TIA
+7%
Aneurysm perforation/rupture during procedure
+2%
Thromboembolic complications
+7%
3
Surgical Clipping
88% Effectiveness• 90% Confidence• 45% Safety• 19 trials• 20K participants
HIGH EvidenceGood ValueDose: N/A (procedure)
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Comparative Safety Scale(Higher is safer)

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45
DangerousModerateSafe

Time to Effect

Immediate

Duration

One-time procedure

Response Rate

95%

Remission Rate

%

Common Side Effects:

Post-operative stroke/ischemia: 10%
Intracranial hematoma/hemorrhage: 3%
Infection (meningitis, wound): 3%
Seizures: 7%
Cranial nerve palsy: 10%
Hydrocephalus: 15%
Cognitive deficits: 10%

Annual Cost of Care

Drug Cost

$200

Monitoring

$3,000

Side Effects

$2,000

Total Annual

$5,200

Cost-Effectiveness

GOOD

QALYs Gained

0.7

Treatment Outcomes
Primary Outcomes
Rebleeding Rate (within 30 days post-SAH)15% (for unsecured aneurysm)
-93.3% (-14% (from 15% to 1%))
Good Functional Outcome (mRS 0-2 at 6 months)35% (proportion achieving mRS 0-2 without definitive aneurysm securing)
+71.4% (+25% (from 35% to 60%))
All-cause Mortality (90-day post-SAH)35% (overall SAH mortality in managed patients without aneurysm securing)
-28.6% (-10% (from 35% to 25%))
Secondary Benefits
Health-related Quality of Life (EQ-5D index at 6 months)0.45 (post-SAH)
+22.2% (+0.10 (from 0.45 to 0.55))
Cognitive Function (MoCA score at 6 months)20/30 (average for SAH survivors)
+10% (+2 points (from 20 to 22))
Need for Re-intervention on Treated Aneurysm (at 5 years)5% (for endovascular coiling)
-80% (-4% (from 5% to 1%))
Common Side Effects
Post-operative stroke/ischemia
+10%
Intracranial hematoma/hemorrhage
+3%
Infection (meningitis, wound)
+3%
4
Blood Pressure Control (e.g., Nicardipine IV)
80% Effectiveness• 85% Confidence• 68% Safety• 20 trials• 5K participants
HIGH EvidenceExcellent ValueDose: Nicardipine: 5 mg/hour IV, titrated up to 15 mg/hour
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Comparative Safety Scale(Higher is safer)

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68
DangerousModerateSafe

Time to Effect

Immediate

Duration

Days to weeks (acute hospitalization)

Response Rate

95%

Remission Rate

%

Number Needed to Harm (NNH)

25

Common Side Effects:

Hypotension: 15%
Tachycardia: 7%
Headache: 7%
Nausea: 7%

Annual Cost of Care

Drug Cost

$800

Monitoring

$1,000

Side Effects

$200

Total Annual

$2,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.5

ICER

$20,000/QALY

Cost per Responder

$1,053

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+80%
Response Rate
+95%
Common Side Effects
Hypotension
+15%
Tachycardia
+7%
Headache
+7%
5
Nimodipine
75% Effectiveness• 85% Confidence• 68% Safety• 17 trials• 4K participants
HIGH EvidenceExcellent ValueDose: 60 mg orally every 4 hours for 21 days
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Comparative Safety Scale(Higher is safer)

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68
DangerousModerateSafe

Time to Effect

Hours to days

Duration

21 days

Response Rate

25%

Remission Rate

%

Number Needed to Treat (NNT)

9

Number Needed to Harm (NNH)

25

Common Side Effects:

Hypotension: 10%
Bradycardia: 3%
Headache: 7%
Nausea: 7%
Liver enzyme elevation: 3%

Annual Cost of Care

Drug Cost

$800

Monitoring

$100

Side Effects

$200

Total Annual

$1,100

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.4

ICER

$30,000/QALY

Cost per Responder

$4,400

Treatment Outcomes
Primary Outcomes
Incidence of Delayed Cerebral Ischemia (DCI)25% of patients
-40% (-10% absolute reduction)
Good Neurological Outcome (Glasgow Outcome Scale 4-5 at 3 months)40% of patients
+30% (+12% absolute increase)
All-cause Mortality (at 3 months)30% of patients
-10% (-3% absolute reduction)
Incidence of Cerebral Infarction (on imaging)20% of patients
-30% (-6% absolute reduction)
Secondary Benefits
Functional Independence (modified Rankin Scale 0-2 at 3 months)35% of patients
+25% (+9% absolute increase)
Need for Rescue Vasospasm Therapy15% of patients
-27% (-4% absolute reduction)
Health-Related Quality of Life (SF-36 Physical Component Summary)35 points (on 0-100 scale)
+17.1% (+6 points)
Common Side Effects
Hypotension
+10%
Bradycardia
+3%
Headache
+7%

Clinical Trial Phases:

Phase 4
6
Tranexamic Acid (TXA)
68% Effectiveness• 70% Confidence• 65% Safety• 1 trials• 3K participants
MODERATE EvidenceModerate ValueDose: Loading dose 1g IV, then 1g every 6-8 hours IV
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Comparative Safety Scale(Higher is safer)

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65
DangerousModerateSafe

Time to Effect

Immediate

Duration

24-72 hours (acute)

Response Rate

20%

Remission Rate

%

Number Needed to Treat (NNT)

8

Number Needed to Harm (NNH)

75

Common Side Effects:

Nausea/vomiting: 12%
Diarrhea: 7%
Thrombotic events (DVT/PE): 3%
Seizures: 0.5%

Annual Cost of Care

Drug Cost

$100

Monitoring

$50

Side Effects

$100

Total Annual

$250

Cost-Effectiveness

MODERATE

QALYs Gained

0.1

ICER

$70,000/QALY

Cost per Responder

$1,250

Treatment Outcomes
Primary Outcomes
Incidence of Rebleeding within 72 hours18%
-50% (-9 percentage points)
Proportion of Favorable Neurological Outcome (mRS 0-2) at 3 months60%
-5% (-3 percentage points)
Incidence of Delayed Cerebral Ischemia (DCI)30%
+15% (+4.5 percentage points)
Secondary Benefits
Incidence of Aneurysm Re-rupture requiring re-intervention15%
-40% (-6 percentage points)
Incidence of Symptomatic Vasospasm25%
+10% (+2.5 percentage points)
Common Side Effects
Nausea/vomiting
+12%
Diarrhea
+7%
Thrombotic events (DVT/PE)
+3%

Clinical Trial Phases:

Phase 4