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Deferoxamine for Spontaneous Intracranial Hemorrhage: A Pilot Study on Neurological and Radiological Outcomes Publisher



Shirani M1 ; Sohrabiasl M2 ; Meshkini A2 ; Mirzaei F2 ; Hashemi SMM1 ; Jafari F3 ; Salami A2 ; Rafiei E1 ; Iranmehr A1, 3
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran
  3. 3. Gamma Knife Radiosurgery Center, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Korean Journal of Neurotrauma Published:2025


Abstract

Objective: Spontaneous intracranial hemorrhage (ICH) is a catastrophic medical condition associated with significant morbidity and mortality. Because the accumulation of unbound iron following ICH contributes to secondary brain injury, deferoxamine, an approved chelation drug, has become the center of attention. However, its therapeutic effects remain a matter of dispute. This double-blind randomized controlled trial aimed to investigate the therapeutic potential of deferoxamine in terms of neurological and radiological outcomes. Methods: The study enrolled 42 participants diagnosed with spontaneous ICH, confirmed by computed tomography, and randomly assigned them to either a deferoxamine treatment group or the placebo control group. The placebo control group received routine treatment plus a placebo, whereas the treatment group received routine treatment conjugated with 7.5 mg/kg of deferoxamine per hour intravenously over the first 3 days. The study compared the hematoma and edema volumes, Glasgow coma scale (GCS) scores, and mortality rates between the 2 groups. Our study employed rigorous randomization and blinding procedures to ensure unbiased results. Results: There was a significant (p<0.05) improvement in the patients’ GCS scores until the fourth day; however, no significant difference was noted thereafter. In addition, both the edema and hematoma volumes were significantly lower in the deferoxamine treatment group versus the placebo control group, as were the length of stay, intubation requirement, and mortality. Conclusion: Deferoxamine administration can, at least within a short timeframe, improve neurological and radiological parameters. Copyright © 2025 Korean Neurotraumatology Society.
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