Early Identification of Secondary Brain Damage in Subarachnoid Hemorrhage: A Role for Glial Fibrillary Acidic Protein
pmid: 16866629
Early Identification of Secondary Brain Damage in Subarachnoid Hemorrhage: A Role for Glial Fibrillary Acidic Protein
Secondary ischaemic deficit adversely affects outcome in patients with subarachnoid hemorrhage (SAH). Astrocytes are vulnerable to ischemia, releasing glial fibrillary acidic protein (GFAP) when challenged. In this study, we followed nine patients with SAH who underwent extra-ventricular drainage for the management of secondary hydrocephalus. Cerebrospinal fluid (CSF) was collected daily for up to 14 days. CSF GFAP was quantified using a standard ELISA. In the patients, we found that the CSF GFAP values were pathologically elevated in 83/89 (93%) of the CSF samples. The levels were highest on day 1 (median = 47.64 ng/mL) and decreased to 11.19 ng/mL on day 3, leveling out at approximately 1 ng/mL after 10 days. In non-survivors, a secondary rise of GFAP levels became significant during the high-risk period for vasospasm, with median levels of 21.76 ng/mL compared to 2.62 ng/mL in the survivors (p = 0.037) on day 6. This study suggests that CSF GFAP levels are of prognostic value in SAH. Additionally, the difference in the slope of GFAP levels between survivors (rapid wash-out) and non-survivors (secondary peaks) may allow difierentiation between primary brain injury from secondary brain damage due to delayed cerebral ischaemia.
- University of Alabama at Birmingham Hospital United States
- University College London United Kingdom
- National Hospital for Neurology and Neurosurgery United Kingdom
- National Institutes of Health United States
- UCL Queen Square Institute of Neurology United Kingdom
Male, Time Factors, Glial Fibrillary Acidic Protein, Humans, Female, Survivors, Middle Aged, Subarachnoid Hemorrhage, Prognosis, Aged, Brain Ischemia
Male, Time Factors, Glial Fibrillary Acidic Protein, Humans, Female, Survivors, Middle Aged, Subarachnoid Hemorrhage, Prognosis, Aged, Brain Ischemia
6 Research products, page 1 of 1
- 2017IsRelatedTo
- 2017IsRelatedTo
- 2017IsRelatedTo
- 2017IsRelatedTo
citations This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).39 popularity This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.Top 10% influence This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).Top 10% impulse This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.Top 10%
