{"doi":"10.1101/2024.09.09.24313246","title":"Safety and Outcomes of Valproic Acid in Subarachnoid Hemorrhage Patients: A Retrospective Study","abstract":"Background and Purpose: Animal studies have suggested that valproic acid (VPA) is neuroprotective in aneurysmal subarachnoid hemorrhage (SAH). Potential mechanisms include an effect on cortical spreading depolarizations (CSD), apoptosis, blood-brain barrier integrity, and inflammatory pathways. However, the effect of VPA on SAH outcomes in humans has not been investigated. Methods: We conducted a retrospective analysis of 123 patients with nontraumatic SAH. Eighty-seven patients had an aneurysmal source and 36 patients did not have a culprit lesion identified. We used stepwise logistic regression to determine the association between VPA and the following: delayed cerebral ischemia (DCI), radiographic vasospasm, and discharge modified Rankin Scale (mRS) score > 3. Results: All 18 patients who received VPA underwent coil embolization of their aneurysm. VPA use did not have a significant association with DCI on adjusted analysis (Odds Ratio, OR = 1.07, 95% CI: 0.20 - 5.80). The association between VPA use and vasospasm was OR = 0.64 (0.19 - 1.98) and discharge mRS > 3 was OR = 0.45 (0.10 - 1.64). Increased age (OR = 1.04, 1.01 - 1.07) and Hunt and Hess (HH) grade > 3 (OR = 14.5, 4.31 - 48.6) were associated with an increased likelihood for poor discharge outcome (mRS > 3). Younger age (OR = 0.96, 0.93 - 0.99), mFS score = 4 (OR = 4.14, 1.81 - 9.45), and HH grade > 3 (OR = 2.92, 1.11 - 7.69) were all associated with subsequent development of radiographic vasospasm. There were no complications associated with VPA administration. Conclusion: We did not observe an association between VPA and the rate of DCI. There may have been a protective association on discharge outcome and radiographic vasospasm that did not reach statistical significance. We found that VPA use was safe and is plausible to be used in a population of SAH patients who have undergone endovascular treatment of their aneurysm. Larger, prospective studies are needed to determine the effect of VPA on outcome after SAH.","journal":"medRxiv","year":2024,"id":503166,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9459,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1352775,"name":"Kushak Suchdev","orcid":"0000-0002-0324-6589","position":1,"is_corresponding":false},{"id":1352776,"name":"Hayley Tatro","orcid":"0000-0001-7161-3611","position":2,"is_corresponding":false},{"id":1353098,"name":"Ava Cascone","orcid":null,"position":3,"is_corresponding":false},{"id":361854,"name":"Joanna C. Yang","orcid":"0000-0001-9106-7080","position":4,"is_corresponding":false},{"id":719437,"name":"Janice Weinberg","orcid":"0000-0002-3503-0061","position":5,"is_corresponding":false},{"id":620424,"name":"Mohamad Abdalkader","orcid":"0000-0002-9528-301X","position":6,"is_corresponding":false},{"id":1352777,"name":"Hormuzdiyar H. Dasenbrock","orcid":"0000-0002-2946-8286","position":7,"is_corresponding":false},{"id":890759,"name":"Charlene Ong","orcid":"0000-0003-2377-3025","position":8,"is_corresponding":false},{"id":329290,"name":"Anna M. Cervantes‐Arslanian","orcid":"0000-0002-6779-0647","position":9,"is_corresponding":false},{"id":109381,"name":"David M. Greer","orcid":"0000-0002-2026-8333","position":10,"is_corresponding":false},{"id":1352778,"name":"Thanh N. Nguyen","orcid":"0000-0002-5919-6170","position":11,"is_corresponding":false},{"id":848484,"name":"Ali Daneshmand","orcid":"0000-0001-7927-2030","position":12,"is_corresponding":false},{"id":294008,"name":"David Y. Chung","orcid":"0000-0002-7149-5851","position":13,"is_corresponding":false},{"id":1352774,"name":"Matthew J. Cobler-Lichter","orcid":"0000-0003-3848-1068","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-19T02:10:27.781502Z","pmid":"39314927","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}