Related Experiment Video
Updated: Oct 6, 2025
Intrastriatal Injection of Autologous Blood or Clostridial Collagenase as Murine Models of Intracerebral Hemorrhage
Published on: July 3, 2014
Homocysteine Plasmatic Concentration in Brain-Injured Neurocritical Care Patients: Systematic Review of Clinical
Maria Paola Lauretta1, Rita Maria Melotti2, Corinne Sangermano3
1Department of Anaesthesia and Pain Management, IRCCS Policlinico S. Orsola-Malpighi of Bologna, University of Bologna, 40138 Bologna, Italy.
Insights
High homocysteine (HHcy) levels are linked to poor outcomes in acute brain injury (ABI). Supplementation with folic acid and B vitamins may reduce neurological risks in neurocritical care patients with severe HHcy.
Area of Science:
- Neuroscience
- Biochemistry
- Critical Care Medicine
Background:
- Hyperhomocysteinemia (HHcy) is an independent risk factor for cardiovascular, neurological, and autoimmune diseases.
- Atherothrombotic events, driven by endothelial dysfunction and inflammation, are key mechanisms of vascular damage.
- This review examines the link between plasma homocysteine (Hcy) levels and acute brain injury (ABI) in neurocritical care settings.
Purpose of the Study:
- To review clinical evidence correlating plasma homocysteine (Hcy) concentrations with acute brain injury (ABI).
- To assess the prognostic value of HHcy in neurocritical care patients.
- To explore potential therapeutic interventions for HHcy in ABI.
Main Methods:
- Systematic literature search of PubMed and EMBASE databases.
- Inclusion of complete studies published in English in peer-reviewed journals.
- Categorization of findings into homocysteine's role in acute ischemic stroke, traumatic brain injury, and intracranial/subarachnoid hemorrhage.
Main Results:
- Elevated HHcy is confirmed as an independent risk factor for ABI.
- HHcy serves as a marker for poor prognosis in stroke, traumatic brain injury, and intracranial/subarachnoid hemorrhage.
- Hcy levels impact patient prognosis and recurrence risk in ABI.
Conclusions:
- Homocysteine is a valuable biochemical marker for risk stratification in neurocritical care.
- Nutraceutical intervention with folic acid, vitamin B6, and B12 can mitigate thrombosis and neurological risks.
- Supplementation may reduce cardiovascular and neurological dysfunction in severe HHcy patients requiring neurocritical care.
Background:
Hyperhomocysteinemia (HHcy) is considered as an independent risk factor for several diseases, such as cardiovascular, neurological and autoimmune conditions. Atherothrombotic events, as a result of endothelial dysfunction and increased inflammation, are the main mechanisms involved in vascular damage. This review article reports clinical evidence on the relationship between the concentration of plasmatic homocysteine (Hcy) and acute brain injury (ABI) in neurocritical care patients.
Materials And Methods:
a systematic search of articles in the PubMed and EMBASE databases was conducted, of which only complete studies, published in English in peer-reviewed journals, were included.
Results:
A total of 33 articles, which can be divided into the following 3 subchapters, are present: homocysteine and acute ischemic stroke (AIS); homocysteine and traumatic brain injury (TBI); homocysteine and intracranial hemorrhage (ICH)/subarachnoid hemorrhage (SAH). This confirms that HHcy is an independent risk factor for ABI and a marker of poor prognosis in the case of stroke, ICH, SAH and TBI.
Conclusions:
Several studies elucidate that Hcy levels influence the patient's prognosis in ABI and, in some cases, the risk of recurrence. Hcy appears as biochemical marker that can be used by neuro-intensivists as an indicator for risk stratification. Moreover, a nutraceutical approach, including folic acid, the vitamins B6 and B12, reduces the risk of thrombosis, cardiovascular and neurological dysfunction in patients with severe HHcy that were admitted for neurocritical care.
