Deferoxamine In the Treatment of Aneurysmal Subarachnoid Hemorrhage (aSAH)
Deferoxamine In the Treatment of Aneurysmal Subarachnoid Hemorrhage (aSAH)
Aneurysmal subarachnoid hemorrhage (aSAH) has a high incidence of mortality and significant
 morbidity, with mortality exceeding 30% in the first two days.The initial injury is related
 to increasing intracranial pressure, cerebral edema, and neuronal injuries associated with
 the release of iron. Iron has been shown to increase the incidence of cerebral edema,
 ischemia, and formation of hydrocephalus. Deferoxamine mesylate (DFO), a hydrophilic
 chelator, creates a stable complex with free iron thus preventing the formation of iron
 related free radicals.

 This trial will evaluate the safety and efficacy of clinical deferoxamine for the treatment
 of aSAH for patients that are admitted to the hospital at the University of Michigan or
 Peking University Health Science Center. Eligible participants will be enrolled and
 randomized to 1 of 2 doses of Deferoxamine or placebo (saline). Information regarding the
 patients will be collected and followed for up to 6 months post discharge.
Inclusion Criteria:

 -  Aneurysmal SAH confirmed with vascular imaging

 -  Aneurysm treated with endovascular or microsurgical intervention

 -  Hunt-Hess ≤ 4

 -  Modified Fisher Grade I-IV

 -  Glasgow Coma Scale (GCS) ≥ 7 following External Ventricular Drain (EVD) placement if
 indicated

 -  First dose of drug can be administered within 24 hours of symptom onset

 -  Functional independence prior to SAH, Modified Rankin Scale (mRS) ≤ 1

 -  Informed consent obtained by patient or legal authorized representative (LAR)

 Exclusion Criteria:

 -  Previous hypersensitivity to or treatment with deferoxamine

 -  Presence of giant aneurysm (>25 mm in size)

 -  Known severe iron deficiency anemia, Hemoglobin (Hgb) g/dl ≤ 7 or transfusion
 dependent

 -  Irreversibly impaired brainstem function

 -  Abnormal renal function, Serum Creatinine> 2 mg/dL

 -  Pre-existing severe disability, mRS ≥ 2

 -  Coagulopathy, including use of anti-platelet or anticoagulant drugs

 -  Known severe hearing loss

 -  Patients with significant respiratory disease such as chronic obstructive pulmonary
 disease, pulmonary fibrosis, or on home oxygen (O2)

 -  Taking iron supplements containing > 325 mg of ferrous iron

 -  Pregnancy

 -  Life expectancy less than 90 days due to co-morbidities

 -  Concurrent participation in another research protocol for investigation of another
 experimental therapy, though observational studies are allowed

 -  Prior history of hepatic dysfunction

 -  Known cytopenia (platelets < 50,000, Absolute neutrophil count < 500)