Cerebrospinal Fluid Catecholamine Levels as Predictors of Outcome in Subarachnoid Hemorrhage

Moussouttas, Michael; Huynh, Thanh; Khoury, John; Lai, Edwin W.; Dombrowski, Keith; Pello, Scott; Pacák, Karel

doi:10.1159/000334660

Cited by 31 publications

(18 citation statements)

References 104 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moussouttas et al (2012) and Dilraj et al (1992) demonstrated that plasma and CSF levels of epinephrine are independent predictors of morbidity and mortality in SAH. Although epinephrine detection assays of blood and urine are well-developed and simplistic, epinephrine should be combined with other markers of disease to increase sensitivity and specificity for SAH.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

Hong¹,

Tosun²,

Kurland³

et al. 2014

Biomarkers

View full text Add to dashboard Cite

Context Subarachnoid hemorrhage (SAH) has a high fatality rate and many suffer from delayed neurological deficits. Biomarkers may aid in the identification of high-risk patients, guide treatment/management and improve outcome. Objective The aim of this review was to summarize biomarkers of SAH associated with outcome. Methods An electronic database query was completed, including an additional review of reference lists to include all potential human studies. Results A total of 298 articles were identified; 112 were reviewed; 55 studies were included. Conclusion This review details biomarkers of SAH that correlate with outcome. It provides the basis for research investigating their possible translation into the management of SAH patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

Hong¹,

Tosun²,

Kurland³

et al. 2014

Biomarkers

View full text Add to dashboard Cite

show abstract

“…Increased sympathetic activation, which has been observed in patients with spontaneous SAH and poor outcome, may directly influence ANP release [27]. In addition to neurohumoral effects, ANP increase may be triggered by therapeutic regulation of fluid balance and systemic vascular resistance [5].…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Midregional Proatrial Natriuretic Peptide in Patients with Hemorrhagic Stroke

et al. 2014

View full text Add to dashboard Cite

Background: Atrial natriuretic peptide (ANP) is a well-known prognostic marker of outcome and mortality in patients with cardiovascular disease. Midregional proatrial natriuretic peptide (MR-proANP) is a stable fragment of the ANP precursor hormone. As a prognostic marker after ischemic stroke, it reliably predicts poststroke mortality and functional outcome. This study aimed to analyze the prognostic value of MR-proANP in patients with hemorrhagic stroke, i.e. subarachnoid (SAH) and intracerebral hemorrhage (ICH). Methods: MR-proANP was analyzed in patients with spontaneous SAH or spontaneous ICH. All patients were prospectively randomized into two treatment arms: (1) a prophylactic normothermia group with a target core temperature 36.5°C using endovascular cooling, and (2) a control group with conventional stepwise predefined fever management using antipyretic medication and surface cooling. Blood samples were obtained on admission and on days 4 and 7. Measurement of MR-proANP was performed in serum using sandwich immunoassay. The primary endpoint was functional outcome [assessed by the Glasgow Outcome Score (GOS)] and the secondary endpoints were mortality within 180 days after hemorrhagic stroke and influence of temperature on MR-proANP. A favorable outcome was defined as GOS 4-5, and the patients were considered to have a poor outcome with a 180-day GOS score between 1 and 3. Results: Analysis of MR-proANP was performed in 24 patients with spontaneous SAH and 22 patients with spontaneous ICH. MR-proANP was elevated on days 4 and 7 as compared to baseline levels (p < 0.05 and p < 0.001, respectively). High MR-proANP levels (>120 pmol/l) were associated with increased mortality and poor outcome (after 180 days; p < 0.05, respectively). There was no significant difference regarding MR-proANP serum concentrations between the endovascular and the control groups. Conclusions: Increased levels of MR-proANP are independently associated with poor functional outcome and increased mortality after 180 days in patients with hemorrhagic stroke. Endovascular temperature control had no significant influence on MR-proANP levels.

show abstract

“…The role of biomarkers for evaluation has not been studied in large cohorts. Small studies suggest that catecholamine levels in cerebrospinal fluid (CSF) are elevated in patients who experience early mortality or disability [28]. Serum S100 has been associated with poor outcome after SAH [29].…”

Section: Aneurysmal Sah – Ruptured Aneurysm (Ria)mentioning

confidence: 99%

European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage

et al. 2013

View full text Add to dashboard Cite

Background: Intracranial aneurysm with and without subarachnoid haemorrhage (SAH) is a relevant health problem: The overall incidence is about 9 per 100,000 with a wide range, in some countries up to 20 per 100,000. Mortality rate with conservative treatment within the first months is 50–60%. About one third of patients left with an untreated aneurysm will die from recurrent bleeding within 6 months after recovering from the first bleeding. The prognosis is further influenced by vasospasm, hydrocephalus, delayed ischaemic deficit and other complications. The aim of these guidelines is to provide comprehensive recommendations on the management of SAH with and without aneurysm as well as on unruptured intracranial aneurysm. Methods: We performed an extensive literature search from 1960 to 2011 using Medline and Embase. Members of the writing group met in person and by teleconferences to discuss recommendations. Search results were graded according to the criteria of the European Federation of Neurological Societies. Members of the Guidelines Committee of the European Stroke Organization reviewed the guidelines. Results: These guidelines provide evidence-based information on epidemiology, risk factors and prognosis of SAH and recommendations on diagnostic and therapeutic methods of both ruptured and unruptured intracranial aneurysms. Several risk factors of aneurysm growth and rupture have been identified. We provide recommendations on diagnostic work up, monitoring and general management (blood pressure, blood glucose, temperature, thromboprophylaxis, antiepileptic treatment, use of steroids). Specific therapeutic interventions consider timing of procedures, clipping and coiling. Complications such as hydrocephalus, vasospasm and delayed ischaemic deficit were covered. We also thought to add recommendations on SAH without aneurysm and on unruptured aneurysms. Conclusion: Ruptured intracranial aneurysm with a high rate of subsequent complications is a serious disease needing prompt treatment in centres having high quality of experience of treatment for these patients. These guidelines provide practical, evidence-based advice for the management of patients with intracranial aneurysm with or without rupture. Applying these measures can improve the prognosis of SAH.

show abstract

Cerebrospinal Fluid Catecholamine Levels as Predictors of Outcome in Subarachnoid Hemorrhage

Cited by 31 publications

References 104 publications

Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

The Prognostic Value of Midregional Proatrial Natriuretic Peptide in Patients with Hemorrhagic Stroke

European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage

Contact Info

Product

Resources

About