SYNERGISTIC NEUROPROTECTION IN SUBARACHNOID HEMORRHAGE: A DUAL-ACTION PROTOCOL COMBINING PH-BUFFERED N-ACETYLCYSTEINE AND GABAERGIC MODULATION TO PREVENT CEREBRAL VASOSPASM

Delayed Cerebral Ischemia (DCI), primarily driven by cerebral vasospasm following Subarachnoid Hemorrhage (SAH), remains a leading cause of morbidity in neurosurgical patients. This paper proposes the Postalcı Protocol, a novel therapeutic intervention involving a targeted subarachnoid lavage. The protocol utilizes a synergistic combination of pH-buffered N-Acetylcysteine (NAC) and a GABAergic agonist. By neutralizing the "toxic iron pool" and re-establishing intracellular glutathione levels while simultaneously buffering the obligatory glutamate efflux via GABA-induced hyperpolarization, this dual-action approach offers a comprehensive defense against ferroptosis and excitotoxicity