Abstract
Background: Patients with nonaneurysmal subarachnoid hemorrhage (SAH) show either perimesencephal (pm)SAH or nonperimesencephalic (non-pm)SAH, with hemorrhage extending into adjacent cisterns. Patients with non-pmSAH have higher risk for a complicated clinical course with cerebral vasospasm (CVS) and worse outcome. Systemic inflammatory response has been linked to CVS occurrence and worse outcome in aneurysmal SAH. We analyzed whether levels of interleukin (IL)-6, a proinflammatory cytokine, differ in patients with pmSAH compared with non-pmSAH.
Methods: The clinical course with attention to symptomatic CVS occurrence and clinical outcome was assessed. Daily systemic IL-6 levels and leukocyte counts (Lc) were measured in the acute phase in 11 patients with pmSAH and in 9 patients with non-pmSAH.
Results: Patients with non-pmSAH had significantly higher IL-6 levels compared to patients with pmSAH (14.7 ± 3.2 vs. 3.0 ± 0.6 pg/ml, p = 0.001). Lc counts did not differ (11.5 ± 0.5 vs. 11.2 ± 0.6 × 103/μl, p = 0.485). Patients with non-pmSAH stayed significantly longer in the neurocritical care unit (16.4 ± 2.1 vs. 10.2 ± 1.1 days, p = 0.012). Symptomatic CVS occurred in two patients with non-pmSAH. Patients with pmSAH had a significantly more favorable outcome, defined as Glasgow Outcome Scale 5.
Conclusion: Higher IL-6 levels in patients with non-pmSAH supports the common observation of more complicated illness course with higher incidence of CVS compared to patients with pmSAH.
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References
Beseoglu K, Pannes S, Steiger HJ, Hanggi D (2009) Long-term outcome and quality of life after nonaneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 152:409–416
Dimopoulou I, Orfanos S, Kotanidou A, Livaditi O, Giamarellos-Bourboulis E, Athanasiou C, Korovesi I, Sotiropoulou C, Kopterides P, Ilias I, Kanellakopoulou K, Armaganidis A (2008) Plasma pro- and anti-inflammatory cytokine levels and outcome prediction in unselected critically ill patients. Cytokine 41:263–267
Greebe P, Rinkel GJ (2007) Life expectancy after perimesencephalic subarachnoid hemorrhage. Stroke 38:1222–1224
Gupta SK, Gupta R, Khosla VK, Mohindra S, Chhabra R, Khandelwal N, Gupta V, Mukherjee KK, Tewari MK, Pathak A, Mathuriya SN (2009) Nonaneurysmal nonperimesencephalic subarachnoid hemorrhage: is it a benign entity? Surg Neurol 71:566–571; discussion 571, 571–572, 572
Hui FK, Tumialan LM, Tanaka T, Cawley CM, Zhang YJ (2009) Clinical differences between angiographically negative, diffuse subarachnoid hemorrhage and perimesencephalic subarachnoid hemorrhage. Neurocrit Care 11:64–70
Kang DH, Park J, Lee SH, Park SH, Kim YS, Hamm IS (2009) Does non-perimesencephalic type non-aneurysmal subarachnoid hemorrhage have a benign prognosis? J Clin Neurosci 16: 904–908
Keller E, Krayenbuhl N, Bjeljac M, Yonekawa Y (2005) Cerebral vasospasm: results of a structured multimodal treatment. Acta Neurochir Suppl 94:65–73
Muroi C, Bellut D, Coluccia D, Mink S, Fujioka M, Keller E (2011) Systemic interleukin-6 concentrations in patients with perimesencephalic non-aneurysmal subarachnoid hemorrhage. J Clin Neurosci. doi:10.1016/j.jocn.2011.03.022
Muroi C, Mink S, Seule M, Bellut D, Fandino J, Keller E (2011) Monitoring of the inflammatory response after aneurysmal subarachnoid haemorrhage in the clinical setting: review of literature and report of preliminary clinical experience. Acta Neurochir Suppl 110:191–196
Sarrafzadeh A, Schlenk F, Gericke C, Vajkoczy P (2010) Relevance of cerebral interleukin-6 after aneurysmal subarachnoid hemorrhage. Neurocrit Care 13:339–346
van Gijn J, van Dongen KJ, Vermeulen M, Hijdra A (1985) Perimesencephalic hemorrhage: a nonaneurysmal and benign form of subarachnoid hemorrhage. Neurology 35:493–497
Whiting J, Reavey-Cantwell J, Velat G, Fautheree G, Firment C, Lewis S, Hoh B (2009) Clinical course of nontraumatic, nonaneurysmal subarachnoid hemorrhage: a single-institution experience. Neurosurg Focus 26:E21
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Muroi, C., Seule, M., Sikorski, C., Dent, W., Keller, E. (2013). Systemic Interleukin-6 Levels Reflect Illness Course and Prognosis of Patients with Spontaneous Nonaneurysmal Subarachnoid Hemorrhage. In: Zuccarello, M., Clark, J., Pyne-Geithman, G., Andaluz, N., Hartings, J., Adeoye, O. (eds) Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 115. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1192-5_17
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