A group of Japanese neurosurgeons have tested supplementation with E-EPA (1.800mg/day) and shown it to be beneficial for patients operated after a subarachoid hemorrage.
Nontraumatic subarachnoid hemorrhage is a neurologic emergency characterized by the extravasation of blood into the spaces covering the central nervous system that are filled with cerebrospinal fluid. The leading cause of nontraumatic subarachnoid hemorrhage is rupture of an intracranial aneurysm, which accounts for about 80 per cent of cases and has a high rate of death and complications.

Cerebral vasospasm following subarachnoid hemorrhage (SAH) is a significant cause of morbidity and mortality. It can cause ischemic brain injury (referred to as "delayed ischemia") and permanent brain damage due to lack of oxygen in parts of the brain. It can be fatal if severe. Recent studies indicate that Rho-kinase plays an important role in the occurrence of such cerebral vasospasm.

Eicosapentaenoic acid (EPA), an n-3 polyunsaturated fatty acid, inhibits sphingosylphosphorylcholine (SPC)-induced Rho-kinase activation in vitro, so this study examined whether EPA prevented cerebral vasospasm occurrence after SAH in patients.

The trial population was 101 patients with SAH subjected to craniotomy and clip application. EPA was orally administered at a daily dose of 1800 mg EPA from day 4 to day 14 to 73 patients; the other 28 constituted the control group, receiving no EPA.

EPA significantly curtailed both the occurrence of symptomatic vasospasm (14% EPA group, 36% control, P = 0.019) and of cerebral infarction because of cerebral vasospasm (4% EPA group, 29% control, P = 0.001). Moreover, the percentage of patients with a clinically good outcome was significantly higher in the EPA group (85%, P = 0.022) than in control (64%); there were no deaths in the EPA group but three (11%) in control (P = 0.020).

"These findings suggest EPA inhibits symptomatic cerebral vasospasm and cerebral infarction after SAH and also improves clinical prognosis" write the authors in Acta Neurologica Scandinavica.