The role of levetiracetam following aneurysmal subarachnoid hemorrhage: current practice and future directions

Seizures complicate the hospital course of up to a quarter of patients suffering from aneurysmal subarachnoid hemorrhage.  Despite limited evidence supporting the role of antiepileptic medications, many practitioners prescribe AEDs with the notion that any clinical benefit likely outweighs the minimal and rare deleterious effects.   Herein we underscore recently published results of a survey of expert clinicians on this topic.  While there was disagreement regarding the necessity to offer pharmacologic prophylaxis, those practitioners that did endorse prophylaxis utilized levetiracetam with far greater frequency than any other AED.  The authors indicate the importance and timeliness of a randomized trial investigating on the topic.