Novel insights into the delayed vasospasm following subarachnoid haemorrhage: importance of proteinase signalling.

This article summarizes the findings of Kameda et al. (this issue of BJP) that suggest a new avenue for the pharmacological treatment of subarachnoid haemorrhage (SAH) involving the combined use of a proteinase inhibitor (argatroban) that targets thrombin and an antioxidant (vitamin C). The findings are presented in the context of previous modalities of treating SAH that are of modest impact and the possibility that inhibiting proteinase-mediated signalling via proteinase-activated receptors like the thrombin PAR1 receptor combined with blocking oxidative stress may provide a new avenue for the treatment of SAH.