To describe and assess the evidence from randomized controlled trials on the efficacy and tolerability of statins in the prevention of vasospasm after aneurysmal subarachnoid hemorrhage.

Data from three relevant studies were retrieved by means of computerized search. Data were extracted on the basis of intention-to-treat principle, the treatment effect was measured as odd's ratio between stalin and placebo. Pooled estimates were computed according to the fixed effects model.

A total of 1 58 patients were included in 3 trials. No significant heterogeneity was found (Q-value =
3.705, df 2, P value = 0.1 57). The combined odds ratio for the responder rate was 0.1 53 in favor of statin, with a 95% Confidence Interval of 0.268 to 0.982. Elevation of ALT and creatine kinase were not significant in the statin group.

High-dose statins on top of standard aneurysmal subarachnoid hemorrhage therapy is effective
and safe based on the available trials of small sample size.