Seizure Prophylaxis With Levetiracetam in Aneurysmal Subarachnoid Hemorrhage - Pilot Study (SPLASH - Pilot)

The purpose of this study is to determine the feasibility of prospectively enrolling and randomizing patients with aneurysmal subarachnoid hemorrhage (aSAH) to receive levetiracetam or not to receive levetiracetam, and documenting in-hospital and follow-up clinical variables.

levetiracetam 500mg in adults, twice daily, administered by mouth, per tube, or IV. The route of administration will be dependent upon the patient's clinical status and ability to tolerate each form. In descending order of preference, route of administration will be: oral, per tube, IV.

The primary outcome will be the number of patients randomized to either levetiracetam administration or no administration of levetiracetam divided by the total number of aneurysmal subarachnoid hemorrhage patients who present to the Vanderbilt University Emergency Department or are directly admitted to the Neuro Intensive Care Unit. (Unit of Measure: numeric fraction)

The Protocol Adherence Yield is calculated by dividing the number of patients completing the study without incurring a protocol deviation by the total number of patients randomized. (Unit of Measure: numeric fraction)

mRS - modified Rankin Scale (0-6): 0 - no symptoms - no significant disability. Able to carry out all usual activities, despite some symptoms - slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities - moderate disability. Requires some help, but able to walk unassisted. - moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted. - Severe disability. Requires constant nursing care and attention, bedridden, incontinent. - dead

GOSE - Glasgow Outcomes Scale - Extended (1-8): - death - vegetative state - lower severe disability - upper severe disability - lower moderate disability - upper moderate disability - lower good recovery - upper good recovery

Inclusion Criteria: ≥ 18 years of age ≤ 75 years of age Newly diagnosed aneurysmal subarachnoid hemorrhage Exclusion Criteria: One or more antiepileptic medication is taken as a pre-admission medication Seizure occurrence in the field or in the emergency department, or anytime before consent could be obtained Inability to obtain informed consent from the patient, or from the patient's appropriate surrogate

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