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Blood-Brain Barrier Disruption Predicts Poor Outcome in Subarachnoid Hemorrhage: A Dynamic Contrast-Enhanced MRI
Laura Llull1,2, Daniel Santana3,4, Alejandra Mosteiro5
1Neurology Department (L.L., A.C., S.A.), Hospital Clínic, Barcelona, Spain.
Stroke
|June 25, 2025
Summary
Blood-brain barrier disruption after subarachnoid hemorrhage correlates with higher levels of inflammatory mediators. Increased white matter permeability is linked to poor clinical outcomes at 90 days.
Area of Science:
- Neurology
- Radiology
- Neuroinflammation
Background:
- Spontaneous aneurysmal subarachnoid hemorrhage (aSAH) causes early blood-brain barrier (BBB) dysfunction.
- The clinical significance and mechanisms of this BBB dysfunction are not well understood.
Purpose of the Study:
- To assess the link between BBB disruption, neuroinflammatory markers, and long-term clinical outcomes after aSAH.
- To evaluate BBB permeability using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).
Main Methods:
- Prospective cohort study of aSAH patients.
- DCE-MRI was used to quantify K-trans values, measuring BBB permeability.
- Circulating levels of IL-8 and PDGF were measured.
- Clinical outcomes were assessed using the modified Rankin Scale at 90 days.
Main Results:
- Higher K-trans values correlated significantly with increased IL-8 and PDGF levels.
- Elevated white matter K-trans values were associated with poor clinical outcomes (modified Rankin Scale >2).
- Adjusted analyses confirmed that elevated K-trans values were an independent predictor of poor outcome.
Conclusions:
- Increased BBB permeability in aSAH patients is associated with higher levels of circulating neuroinflammatory mediators.
- White matter permeability alterations may serve as a biomarker and therapeutic target for improving clinical recovery after aSAH.
