Aneurysmal Subarachnoid Hemorrhage Trial RandOmizing Heparin

Exclusion criteria

• . Angio-negative SAH.
• . History or imaging suggesting that the current hemorrhage presentation is a recent re-rupture of the aneurysm. Prior sentinel headache with negative CT or prior sentinel headache where the patient did not seek medical attention does not exclude the patient.
• . Surgical Clipping (or plan for clipping) of the ruptured aneurysm or any non- ruptured aneurysm on the same admission.
• . Aneurysm is identified to be traumatic, mycotic, blister or fusiform type by catheter DSA.
• . Any intracranial stent placement or non-coil intra-aneurysmal device where dual- antiplatelet therapy is needed during admission.
• . Patient has additional aneurysm(s) that are untreated and could reasonably be considered a possible alternate cause of the aSAH based on the observed bleeding pattern. Adequate treatment of these aneurysms by coiling embolization would result in the aneurysms no longer causing an exclusion. MRI may be used in some situations to determine that the associated aneurysms did not rupture based on lack of blood seen adjacent to the additional aneurysms.
• . Patient received heparin in any form within the last 100 days prior to current presentation / admission.
• . Thrombocytopenia (platelet count less than 100,000 - assuming clumping has been ruled out as a cause).