Abstract Details

Title CSF Inflammatory and Vasoactive Mediators Associated with Poor Functional Outcome in Subarachnoid Hemorrhage (SAH) Patients.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S15 - Intracerebral Hemorrhage and SAH (1:33 PM-1:44 PM)

Poster/Presentation
Number 004

Objective

To study the association of CSF inflammatory and vasoactive mediators with poor functional outcome in subarachnoid hemorrhage (SAH).

Background Recent evidence suggest that inflammation may play an important role in the pathogenesis of vasospasm and delayed cerebral ischemia (DCI) following SAH. We aimed to explore a panel of cytokines and vasoactive mediators in CSF of SAH patients to identify candidate inflammatory biomarkers.

Design/Methods

CSF samples were collected through an external ventricular drain (EVD) in a prospective SAH cohort (N= 67). We evaluated modified Rankin Scale (mRS) score at 3-month intervals and assessed the occurrence of vasospasm. Poor functional outcome was defined as mRS >2. Angiographic vasospasm was defined as >50% reduction in the caliber of any vessel on post-SAH day 7 cerebral angiogram. We compared the CSF profile of 28 cytokines (Human Magnetic Luminex Assay, R&D systems) in post-SAH day 1, 3 and 5 by outcome. Continuous variables were compared with Student’s t or Wilcoxon rank sum test depending on data distribution.

Results

In the SAH cohort (mean age 55.1, 69% female), 67% had a Hunts and Hess ≥3 and 89% had a modified Fischer scale of ≥3. 48% had poor 3-month outcome and 36% had poor 6-month outcome. Out of the 28 cytokines, 3 were below measurement range and were excluded from analysis: CCL11/Eotaxin, IL10 and IL5. The top 3 markers showing strongest association with outcome were CSF VEGFR1 (p=0.0014), IL12p70 (p=0.0023) and CCL5/RANTES (p=0.0038).

Conclusions These study results suggest a possible association between elevated VEGFR1 and poor functional outcome following SAH. Further targeted studies are necessary to investigate the role of CSF VEGFR1, IL12p70 and CCL5/RANTES and SAH outcome.

Authors/Disclosures
Aisha R. Saand, MD (UPMC) PRESENTER	No disclosure on file
Fang Yu, Jr., MD (University of Pittsburgh)	No disclosure on file
Jong W. Lee, MD, PhD (Brigham and Women's Hospital)	The institution of Dr. Lee has received research support from NIH. The institution of Dr. Lee has received research support from NIH. The institution of Dr. Lee has received research support from UCB. Dr. Lee has received personal compensation in the range of $10,000-$49,999 for serving as a Contract work with Teladoc.
	No disclosure on file
MingMing Ning, MD (Mass General Hospital/Harvard Medical School)	No disclosure on file
Eng Lo, MD (Massachusetts General Hospital)	Eng Lo, MD has nothing to disclose.
Sherry Hsiang-Yi Chou, MD (Departmnt of Neurology, Northwestern Feinberg School of Medicine)	Dr. Hsiang-Yi Chou has received personal compensation for serving as an employee of NIH. An immediate family member of Dr. Hsiang-Yi Chou has received personal compensation for serving as an employee of Wells Fargo. Dr. Hsiang-Yi Chou has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Grace Therapeutics. The institution of Dr. Hsiang-Yi Chou has received research support from The Neurocritical Care Society. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Board of Director member with United Council of Neurologic Specialties that is relevant to AAN interests or activities. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Co-chair/chair-elect, the Neurocritical Care Committee with American Heart Association, the Stroke Council that is relevant to AAN interests or activities. Dr. Hsiang-Yi Chou has a non-compensated relationship as a Co-chair/chair ellect, the Neurocritical Care Special Interest Group with American Neurologic Association that is relevant to AAN interests or activities.

��ɫ��

��ɫ��