S-100B and NSE: markers of initial impact of subarachnoid haemorrhage and their relation to vasospasm and outcome.
S100-B and neuron specific enolase (NSE) are known predictors of outcome in head injured and stroke patients. This study was conducted to test the hypothesis that S-100B and NSE can predict the development of vasospasm and outcome within the first 3 days after subarachnoid haemorrhage (SAH). Fifty-one SAH patients (mean age 51+/-11 years, male : female ratio 1.0 : 1.6, mean World Federation of Neurological Surgeons [WFNS] Grade 3+/-1.5) were included in the study. S100-B and NSE were recorded in venous blood across the first 3 days post-SAH. Vasospasm was diagnosed if mean blood flow velocity of the middle cerebral artery was greater than 120 cm/s and Lindegaard ratio >3. Glasgow Outcome Score (GOS) and cranial CT scans were recorded at 6 months. Normal, intermediate and high S-100B values were seen in 24%, 51% and 25% of patients, respectively. In patients with S-100B>1 microg/L, Fisher Grade 4 and WFNS 4-5 were both seen in 77% of cases. S-100B was significantly higher in those patients who did not develop vasospasm. In addition, S-100B values were significantly higher in those patients who died than in those with unfavourable or favourable outcome. NSE was normal, intermediate and high in 82%, 8% and 10% of patients, respectively. Patients with WFNS 4-5 and/or Fisher Grade 4 had significantly higher NSE values than all others. Across the first 3 days after SAH, measuring S-100B is useful to predict outcome and vasospasm.
Oertel
Matthias
M
Department of Neurosurgery, University Hospital Giessen, Klinikstrasse 29, Giessen, Germany. matthias.oertel@neuro.med.uni-giessen.de
Schumacher
Ute
U
McArthur
David L
DL
Kästner
Stefanie
S
Böker
Dieter-Karsten
DK
D000367:Age Factors; D015415:Biomarkers / Q000097:blood*; D001921:Brain / Q000098:blood supply; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood*; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D020127:Recovery of Function; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000150:complications; D020301:Vasospasm, Intracranial / Q000097:blood* / Q000209:etiology
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase