BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) is a relatively rare cause 
of stroke with a high rate of morbidity and mortality, primarily due to the 
occurrence of delayed vasospasm. To date, many therapies have been proposed to 
help prevent vasospasm, but very few have been proven effective. The initiation 
of statin therapy after SAH may be effective in reducing the incidence of 
vasospasm; however, the only studies that have examined this effect have been 
small. This meta-analysis attempted to determine whether statins reduce 
morbidity and mortality after aneurysmal SAH.
METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials 
were searched for randomized, controlled trials relating to the use of statins 
in SAH. Foreign language and abstract articles were included. Two independent 
reviewers assessed studies for eligibility, data extraction, and quality. 
Primary outcome was the incidence of radiographically confirmed clinical 
vasospasm; secondary outcomes were incidence of delayed ischemic deficits and 
mortality.
RESULTS: The incidence of vasospasm (relative risk [RR]=0.73; 95% CI, 0.54 to 
0.99), delayed ischemic deficits (RR=0.38; 95% CI, 0.17 to 0.83), and mortality 
(RR=0.22; 95% CI, 0.06 to 0.82) were significantly reduced in the statin group. 
For these outcomes, we calculated a number needed to treat of 6.25, 5, and 6.7, 
respectively.
CONCLUSIONS: Initiation of statin therapy after aneurysmal SAH significantly 
reduces the incidence of vasospasm, delayed ischemic deficits, and mortality. 
This is consistent with animal research and retrospective studies and supports 
the routine use of statins in the care of patients with aneurysmal SAH.