Conclusion And Future Directions

Despite numerous clinical trials, most studies have shown little, no, or inconsistent benefits of proposed interventions, compared to placebo. The failure of these trials is multifactorial, related to the underlying complexity of the disease, inadequate power, and the lack of appropriate, sensitive, and specific measures of clinical endpoints. Nevertheless, clinical trials must continue, because the morbidity and mortality of early rebleeding and vasospasm remain theoretically preventable. With increased attention to detail, outcomes, and study design, as well as an improved understanding of the biochemical pathways that result in vasospasm, effective interventions will surely be developed and tested successfully in future clinical trials.

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