Cerebrospinal fluid adrenomedullin concentration correlates with hyponatremia and delayed ischemic neurological deficits after subarachnoid hemorrhage

Cerebrovascular Diseases
Yoshitaka KuboAkira Ogawa

Abstract

Adrenomedullin (AM), a vasorelaxant peptide, is secreted into the cerebrospinal fluid (CSF) from the choroid plexus and can exert natriuretic effects in the kidney. CSF AM concentration is elevated 7-10 days after the onset of aneurysmal subarachnoid hemorrhage (SAH). The aim of the present study was to determine whether CSF AM concentrations correlate with hyponatremia and delayed ischemic neurological deficits (DIND) after SAH. CSF and plasma concentrations of AM, brain natriuretic peptide, and atrial natriuretic peptide concentrations were measured in 32 patients with SAH who underwent aneurysmal clipping within 48 h of onset. CSF and blood samples were obtained from these patients during the early period (days 1-3, day 0 being regarded as the day of SAH onset) and the late period (days 8-10). In all patients, AM concentration during the early and late periods was significantly higher in the CSF than in the plasma (p = 0.0028 and p < 0.0001). In addition, CSF AM concentration was significantly higher during the late period than during the early period (p < 0.0001). Hyponatremia (plasma sodium <135 mmol/l) was present in 11 patients (34.4%) during the late period, and DIND developed in 6 patients (19%) between day 5 and day 1...Continue Reading

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Citations

Apr 13, 2010·Neurosurgery Clinics of North America·Katja E Wartenberg, Stephan A Mayer
Apr 13, 2010·Neurosurgery Clinics of North America·Alan H YeeEelco F M Wijdicks
Mar 30, 2017·Fluids and Barriers of the CNS·Jianming XiangRichard F Keep
Sep 8, 2009·Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi·Guang-jian LiuJin-quan Hu
Oct 17, 2009·Neurosurgery·Maryam Rahman, William A Friedman
Jun 19, 2020·The Neurohospitalist·David P LernerAyush Batra
Jul 3, 2021·Current Issues in Molecular Biology·Francisco J Julián-VillaverdeAlfredo Martínez

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