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eNOS upregulation→vasospasm reduction→neuroprotection
Statins may improve outcomes after subarachnoid hemorrhage through neuroprotective mechanisms including anti-inflammatory effects, upregulation of endothelial nitric oxide synthase, and attenuation of cerebral vasospasm. Evidence includes translational systematic reviews and meta-analyses of clinical studies, though the support ratio is only 10% and some contradicting evidence exists. This is a researcher-prioritized domain with active investigation.
“To explore the clinical effect of nimodipine combined with statins in the treatment of subarachnoid haemorrhage.”
— Application of nimodipine combined with statins in the treatment of subarachnoid haemorrhage. (2025)DOI“Statins Improve Clinical Outcome After Non-aneurysmal Subarachnoid Hemorrhage: A Translational Insight From a Systematic Review of Experimental Studies.”
— Statins Improve Clinical Outcome After Non-aneurysmal Subarachnoid Hemorrhage: A Translational Insight From a Systematic Review of Experimental Studies. (2021)DOI“Effect of statins on functional outcome and mortality following aneurysmal subarachnoid hemorrhage - Results of a meta-analysis, metaregression and trial sequential analysis.”
— Effect of statins on functional outcome and mortality following aneurysmal subarachnoid hemorrhage - Results of a meta-analysis, metaregression and trial sequential analysis. (2021)DOI“Statin use was significantly associated with a reduced risk of SAH.”
— Association Between Statin Use and Risk of Subarachnoid Hemorrhage: A Case-Control Study Using Large-Scale Claims Data. (2025)DOI“Statins may improve outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH) but randomized controlled trials, including all patients with aSAH whatever their clinical severity, were negative.”
— Pravastatin may improve neurological outcome following low-grade aneurysmal subarachnoid hemorrhage. (2022)DOI“Statins are used in clinical practice to prevent from complications such as cerebral vasospasm (CVS) after aneurysmal subarachnoid hemorrhage (aSAH).”
— Optimal Course of Statins for Patients With Aneurysmal Subarachnoid Hemorrhage: Is Longer Treatment Better? A Meta-Analysis of Randomized Controlled Trials. (2021)DOI“Pleiotropic effects of statins may be beneficial in alleviating cerebral vasospasm (VS) and improving outcome after aneurysmal subarachnoid hemorrhage (aSAH).”
— The impact of pre-ictal statin use on vasospasm and outcome in aneurysmal subarachnoid hemorrhage. (2023)DOI“In every hospital in Japan, until 2022, the primary treatment for preventing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) involved a combination of ozagrel sodium (Oz), fasudil hydrochloride (Fs), cilostazol, and statins.”
— Impact of Clazosentan on Vasospasm Reduction and Functional Recovery after Aneurysmal Subarachnoid Hemorrhage. (2024)DOI“Effects of clazosentan, cilostazol, and statins on aneurysmal subarachnoid hemorrhage: A protocol for systematic review and meta-analysis.”
— Effects of clazosentan, cilostazol, and statins on aneurysmal subarachnoid hemorrhage: A protocol for systematic review and meta-analysis. (2020)DOI“Statins in Subarachnoid Hemorrhage to Prevent Delayed Cerebral Ischemia: Old Drugs for New Strategies?”
— Statins in Subarachnoid Hemorrhage to Prevent Delayed Cerebral Ischemia: Old Drugs for New Strategies? (2024)DOI“Although other drugs, including nicardipine, cilostazol, statins, clazosentan, magnesium and heparin, have been expected to have beneficial effects on DCI, there has been no convincing evidence supporting the routine use of those drugs in patients with aneurysmal subarachnoid hemorrhage in clinical ”
— An overview of pharmacotherapy for cerebral vasospasm and delayed cerebral ischemia after subarachnoid hemorrhage (2021)DOI