BACKGROUND AND PURPOSE: A recent meta-analysis investigating the efficacy of 
statin treatment in patients with aneurysmal subarachnoid hemorrhage reported a 
reduced incidence of vasospasm, delayed cerebral ischemia, and mortality in 
statin-treated patients. However, the meta-analysis was criticized for its 
methodology, and several retrospective studies found no beneficial effect. We 
present the results of a new systematic review, which differs from the previous 
systematic review in its methodology, and by inclusion of the results of a 
fourth randomized, placebo-controlled trial. Summary of Review- All randomized, 
placebo-controlled trials investigating the effect of statins on vasospasm, 
delayed cerebral ischemia, and functional outcome in patients with aneurysmal 
subarachnoid hemorrhage were included. Outcomes were the number of patients with 
transcranial Doppler vasospasm, delayed cerebral ischemia, poor outcome, and 
mortality during follow-up. Effect sizes were expressed in (pooled) risk ratio 
estimates. Data were pooled using random-effects models.
RESULTS: In 4 studies, a total of 190 patients were included. No statistically 
significant effect was observed on transcranial Doppler vasospasm (pooled risk 
ratio, 0.99 [95% CI, 0.66 to 1.48]), delayed cerebral ischemia (pooled risk 
ratio, 0.57 [95% CI, 0.29 to 1.13]), poor outcome (pooled risk ratio, 0.92 [95% 
CI, 0.68 to 1.24]), or mortality (pooled risk ratio, 0.37 [95% CI, 0.13 to 
1.10]).
CONCLUSIONS: The results of the present systematic review do not lend 
statistically significant support to the finding of a beneficial effect of 
statins in patients with aneurysmal subarachnoid hemorrhage as reported in a 
previous meta-analysis.