Endothelial cell activation after subarachnoid hemorrhage.

Area of Science:

• Neuroscience
• Vascular Biology
• Critical Care Medicine

Background:

• Animal studies suggest endothelial cell activation contributes to cerebral ischemia following subarachnoid hemorrhage (SAH).
• Endothelial cell activation markers, ED1-fibronectin (ED1-fn) and von Willebrand factor (vWf), are potential indicators of vascular injury.
• Assessing these markers in SAH patients can elucidate their role in disease progression.

Purpose of the Study:

• To measure plasma concentrations of ED1-fn and vWf in patients with aneurysmal SAH.
• To investigate the relationship between these markers and initial clinical status, treatment, and delayed cerebral ischemia.
• To explore the dynamic changes in endothelial activation markers post-SAH.

Main Methods:

• Blood samples were collected from 27 patients with aneurysmal SAH.
• ED1-fn and vWf plasma concentrations were measured.
• Patients underwent surgical (19), endovascular (7), or no (1) treatment for aneurysms.
• Delayed cerebral ischemia was monitored in 12 patients.

Main Results:

• Initial ED1-fn and vWf levels were significantly higher in SAH patients compared to reference values.
• Elevated marker concentrations were associated with poorer initial clinical condition.
• Marker levels increased significantly after surgical intervention and following ischemic episodes.

Conclusions:

• Plasma concentrations of ED1-fn and vWf are elevated early after SAH.
• These elevations are linked to the patient's clinical condition upon admission.
• Increased concentrations post-surgery and post-ischemia suggest a dynamic role for endothelial activation in SAH.
• The precise causal role of endothelial activation in delayed cerebral ischemia remains to be determined.