• Isabela Costola Windlin, Bruno Braga Sisnando da Costa, João Paulo Mota Telles, Leonardo B Oliveira, Edwin Koterba, Vitor Nagai Yamaki, Nicollas Nunes Rabelo, SollaDavi Jorge FontouraDJFDepartment of Neurology, Hospital das Clínicas FMUSP, University of São Paulo, São Paulo, Brazil., Manoel Jacobsen Teixeira, and Eberval Gadelha Figueiredo.
• Department of Neurology, Hospital das Clínicas FMUSP, University of São Paulo, São Paulo, Brazil.
• World Neurosurg. 2024 Sep 14.

BackgroundAneurysmal subarachnoid hemorrhage (aSAH) is associated with a high incidence of long-term cognitive impairment, decreased quality of life (QoL), and psychiatric disorders. The effects of glibenclamide on such outcomes in the setting of aSAH are unknown.ObjectiveTo assess the impact of glibenclamide in patients with aSAH on cognitive performance, QoL, and emotional aspects.MethodsPatients identified with aSAH were randomly allocated to receive 5 mg of glibenclamide for 21 days or placebo, starting within 96 hours of the ictus. After 6 months, patients were evaluated with Montreal Cognitive Assessment test (cognitive performance), Medical Outcomes Short-form Health Survey (QoL), and Hospital Anxiety and Depression Scale and Screen for Post-traumatic Stress Symptoms (emotional aspects).ResultsThe mean Montreal Cognitive Assessment score was 22.5 ± 6.2. No statistically significant difference was found between groups, with a mean score of 21.7 ± 6.4 in the Glibenclamide group and 23.4 ± 6.2 in the placebo group (P = 0.392). A score <23 was observed in 16 patients (35.6%) and its frequency was similar between groups (P = 0.900). The most frequently impaired domains were Attention (N = 21/45; 46.7%) and Visuospatial (18/45; 40.0%). Impairment of each domain was similar between groups (P > 0.05). In each domain, the mean score was similar between groups (P > 0.05). The Hospital Anxiety and Depression Scale scores did not differ between groups (P > 0.05). The mean Screen for Post-traumatic Stress Symptoms score as well as the mean scores of its domains were similar between groups (P > 0.05).ConclusionsGlibenclamide did not improve cognitive performance, QoL, and emotional aspects after 6 months of follow-up of aSAH survivors.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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