Efficacy of pregabalin in the treatment of acute cerebral hemorrhage and its influence on prognosis

Introduction Acute cerebral hemorrhage leads to high disability and mortality. Pregabalin, an α2δ1 subunit inhibitor, may reduce NMDA receptor–mediated neuronal injury and improve neurological outcomes. Methods In this study, 158 patients with acute cerebral hemorrhage underwent minimally invasive hematoma evacuation and were assigned to receive either pregabalin or placebo for 2 weeks. Primary outcomes included hematoma volume, serum MMP2/MMP9 levels, neurological function (NIHSS), quality of life (ADL), and prognosis (GOS). Results After 2 weeks of treatment, the pregabalin group showed significantly smaller hematoma volume compared with the control group (p < 0.01). Serum MMP2 and MMP9 levels were also significantly lower in the pregabalin group (both p < 0.01). At 12-week follow-up, patients receiving pregabalin demonstrated better neurological recovery (NIHSS, p < 0.01), improved quality of life (ADL, p < 0.01), and a higher proportion of favorable GOS outcomes (54.9% vs. 31.9%, p = 0.022). Conclusion Pregabalin adjunct therapy significantly reduces hematoma volume, decreases MMP2/MMP9 levels, and improves neurological function and prognosis in patients with acute cerebral hemorrhage.