Aspirin still unproven as therapy for curbing brain aneurysm growth

Cincinnati -- Could an aspirin a day keep an aneurysm at bay?

That was the question asked by stroke researchers in the University of Cincinnati Department of Neurosurgery. The researchers reviewed the cases of 186 patients who had unruptured intracranial (brain) aneurysms that were being monitored for growth at Mayfield Brain & Spine.

They found a tiny difference between patients who took an aspirin daily and those who did not take any aspirin. Aneurysms in the group that took aspirin grew in 11.9% of patients (3 percent per year) while aneurysms in the non-aspirin group grew in 16.5% (4 percent per year). Growth was measured by brain scans.

"Although patients on a daily aspirin regimen demonstrated a lower rate of aneurysm growth, the difference was not statistically significant," said Andrew Ringer, MD, a neurosurgeon with Mayfield Brain & Spine and the study’s principal investigator. "We need to conduct additional research that involves a larger number of patients from multiple centers."

The research team is plans to explore additional data collected from thousands of patients treated by the Mayfield Clinic to see if this trend continues, Dr. Ringer said.

The poster is being displayed February 20-21 at the 2017 Annual Meeting of the American Association of Neurological Surgeons / Congress of Neurological Surgeons Joint Cerebrovascular Section in Houston.

A brain aneurysm is bulge on an artery wall that can rupture as it grows thinner and weaker, releasing blood into the space between the brain and the skull, a potentially catastrophic event called a subarachnoid hemorrhage. Of the 30,000 Americans who experience a ruptured brain aneurysm each year, according to the Brain Aneurysm Foundation, 15 percent of patients with a subarachnoid hemorrhage die before reaching the hospital, while 4 out of 7 who recover will have disabilities.

Dr. Ringer, a professor of neurosurgery, said that because the aspirin study was retrospective, the researchers could not be sure that patients were taking aspirin as prescribed. A prospective study in which patients are divided into closely monitored groups – those taking aspirin and those not taking aspirin – would provide greater clarity, Dr. Ringer said.

"It is in the public’s interest to find out whether an inexpensive and accessible drug can help keep small, non-threatening brain aneurysms from becoming larger, more dangerous aneurysms that require endovascular or surgical intervention," Dr. Ringer said.

Additional co-investigators in the aspirin and aneurysm study are Christopher Carroll, MD, Ryan Tackla, MD, William Jeong, MD, Shawn Vuong, and Joseph Serrone, MD.

The study received no internal or external funding. The investigators stated no conflicts of interest.

Mayfield Brain & Spine is the full-service patient care provider of the Mayfield Clinic, one of the nation's leading physician organizations for neurosurgical treatment, education, and research. With more than 20 specialists in neurosurgery, interventional neuroradiology, physical medicine and rehabilitation, and pain management, Mayfield Brain & Spine treats 25,000 patients from 35 states and 13 countries in a typical year. Mayfield physicians specialize in the treatment of back and neck pain, sciatica, Parkinson's disease, essential tremor, NPH, epilepsy, brain and spinal tumors, stroke, moyamoya, brain aneurysms, Chiari malformation, scoliosis, kyphosis, facial pain, facial twitch, trauma, concussion, spinal cord injury, and carpal tunnel. As leading innovators in their field, Mayfield physicians have pioneered surgical procedures and instrumentation that have revolutionized the medical art of neurosurgery for spinal diseases and disorders, brain tumors, and neurovascular diseases and disorders.