Early Diagnosis of Delayed Cerebral Ischemia: Possible Relevance for Inflammatory Biomarkers in Routine Clinical Practice?

World Neurosurgery
Bishwas ChamlingAnke Höllig

Abstract

Delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is one of the main causes of neurologic deterioration. However, it frequently evades timely detection. Early identification and effective reversal may improve the clinical outcome. In this prospective study, we evaluate several serum inflammatory markers after aneurysmal SAH with regard to the occurrence of DCI. On days 1, 4, 7, 10, and 14 after SAH, leucocyte count, C-reactive protein, interleukin 6, E-selectin, matrix metallopeptidase 9, intercellular adhesion molecule 1, and leukemia inhibitory factor were assessed in patients' serum samples. Using a Cox regression model (SPSS 21.0), associations of baseline parameters, maximum and delta (maximum minus baseline) values with occurrence of DCI were evaluated. Considering the assessed parameters, leucocyte count (high baseline and delta values) matches most closely with occurrence of DCI. Although baseline levels of C-reactive protein are also associated with occurrence of DCI, neither maximum (only on a borderline level) nor delta levels do so. Our data analysis identified leucocyte count as the parameter most likely associated with occurrence of DCI. However, because of its lack of specificity leucocyte count...Continue Reading

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Citations

Jul 11, 2019·Annals of Neurology·Matthew B BeversW Taylor Kimberly
Mar 12, 2020·Stroke; a Journal of Cerebral Circulation·India A LissakEric S Rosenthal
Oct 25, 2017·Current Atherosclerosis Reports·Joseph R Geraghty, Fernando D Testai
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Sep 30, 2020·Acta Neurologica Scandinavica·Sandra Bjerkne WennebergLinda Block
May 1, 2021·International Journal of Molecular Sciences·Matthias Simon, Alexander Grote
Aug 13, 2021·Frontiers in Neurology·Aaron M GusdonHuimahn Alex Choi

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