INTRODUCTION: Cerebrolysin is a neuroprotective drug used in the treatment of 
acute ischemic stroke. To our knowledge, this drug has never been evaluated in 
patients with aneurysmal subarachnoid hemorrhage (SAH). The aim of this study 
was to evaluate the effect of Cerebrolysin in patients with aneurysmal SAH.
METHODS: Aneurysmal SAH patients who had their aneurysm obliterated at our 
institution from 2007 to 2016 were retrospectively studied. Patients received 
Cerebrolysin treatment or standard care only (control group). Subgroup analyses 
were performed according to Hunt and Hess grade (good grade ≤ 2, N = 216; poor 
grade ≥ 3, N = 246) and treatment procedure (clip or coil).
RESULTS: In good-grade patients (N = 216), clinical outcomes and mortality did 
not differ significantly between the control and Cerebrolysin groups. In 
poor-grade patients (N = 246), the mortality rate was significantly lower in the 
Cerebrolysin group (8.7%) than in the control group (25.4%, p = 0.006). In 
patients who received microsurgical clipping (N = 328), the mortality rate was 
significantly lower in the Cerebrolysin group (7.3%) than in the control group 
(18.5%, p = 0.016).
CONCLUSION: Cerebrolysin injection during the acute period of SAH appeared to 
reduce the mortality rate, especially in poor-grade patients. This study 
suggests the potential of Cerebrolysin for treating aneurysmal SAH. Further 
studies are needed to confirm our results.