title: Serum glial fibrillary acidic protein is related to focal brain injury and outcome after aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  Aneurysmal subarachnoid hemorrhage (aSAH) stands out from other subtypes of stroke because of the high early mortality and the risk of complications. Serum glial fibrillary acidic protein (s-GFAP) concentrations are increased after stroke. The aim of this study was to investigate whether s-GFAP could be used as a marker of brain damage and outcome after aSAH.
  
  
  METHODS
  Serum samples were obtained on a regular basis from 116 adults during a 2-week period after aSAH and analyzed using an enzyme-linked immunosorbent assay. The World Federation of Neurological Surgeons scale was used for neurological evaluation. Outcome was assessed after 1 year and categorized according to the Extended Glasgow Outcome Scale.
  
  
  RESULTS
  Increased s-GFAP levels were seen in 81 of the 116 patients. Maximum s-GFAP correlated with World Federation of Neurological Surgeons scale on arrival and on days 10 to 15 (r=0.37, P<0.001 and r=0.47, P<0.001, respectively). Furthermore, maximum s-GFAP levels were increased in the patient group with radiological signs of focal lesions acute or at 1 year, compared with the group without focal lesions (P<0.001 in both comparisons). Patients with secondary events (re-bleeding or ischemia) reached maximum levels later in the series and both maximum and final s-GFAP levels increased compared with the levels in patients without secondary events (P<0.001 in all 3 comparisons). Finally, maximum s-GFAP correlated with outcome (r=-0.48, P<0.001) and s-GFAP was an independent predictor of dichotomized outcome.
  
  
  CONCLUSIONS
  s-GFAP provides information about brain injury severity and outcome after aSAH, which can be useful as a complement to clinical data.
authors: Department of Neurology, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, University of Göteborg, Göteborg, Sweden. karin.nylen@neuro.gu.se
authors: Karin
authors: K
authors: Nylén
authors: Ludwig Z
authors: LZ
authors: Csajbok
authors: Martin
authors: M
authors: Ost
authors: Anas
authors: A
authors: Rashid
authors: Kaj
authors: K
authors: Blennow
authors: Bengt
authors: B
authors: Nellgård
authors: Lars
authors: L
authors: Rosengren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000209:etiology; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000150:complications
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein