• Ferdinand K Hui, Albert J Schuette, Michael Lieber, Alejandro M Spiotta, Shaye I Moskowitz, Daniel L Barrow, and C Michael Cawley.
• Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA. huif@ccf.org
• Neurosurgery. 2012 Mar 1;70(3):702-5; discussion 705-6.

Backgroundε-Aminocaproic acid (EACA) has been used to reduce the rate of cerebral aneurysm rerupture before definitive treatment. In centers administering EACA to patients with a subarachnoid hemorrhage (SAH), patients eventually diagnosed with angiographically negative subarachnoid hemorrhage (ANSAH) may also initially receive EACA, perhaps placing them at increased risk for ischemic complications.ObjectiveTo evaluate the effect of short-term EACA on outcomes and secondary measures in patients with ANSAH.MethodsWe conducted a retrospective study of 454 consecutive SAH patients over a 2-year period under a current protocol for EACA use. Patients were excluded if a source for the SAH was discovered, yielding a total of 83 ANSAH patients. The patients were assigned to groups that did or did not receive EACA. The primary end points of the study were ischemic complications, pulmonary emboli, vasospasm, ventriculoperitoneal shunting rates, and outcomes.ResultsStatistical analysis yielded no significant difference between the 2 arms with respect to any of the end points: vasospasm (P = .65), deep vein thrombosis (P = .51), pulmonary embolism (P = 1.0), stroke (P = 1.0), myocardial infarction (P = 1.0), and ventriculoperitoneal shunt (P = .57). There was no statistically significant outcome difference using the modified Rankin Scale (P = .30).ConclusionShort-term (<72 hour) application of EACA does not result in an increase in adverse events in patients with ANSAH.

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