Association between serum ferritin level and perihematoma edema volume in patients with spontaneous intracerebral hemorrhage.
OBJECTIVE
Preclinical evidence indicates that iron plays a key role in mediating neuronal injury and edema formation after intracerebral hemorrhage (ICH). However, the clinical role of iron in patients with ICH has not been well studied. We undertook this exploratory study to investigate the association of serum ferritin, as an indicator of body iron load, with perihematoma edema after ICH.


METHODS
We retrospectively reviewed prospectively-collected clinical and laboratory data from 23 consecutive patients with acute spontaneous ICH who had a CT scan and serum ferritin checked on admission, and a follow-up CT scan 3 to 4 days afterward. We measured hematoma and edema volumes on admission and follow-up scans, and calculated the relative edema volume to correct for hematoma volume. We used Spearman correlation coefficient to determine the association of various variables with relative perihematoma edema volume.


RESULTS
Whereas the median hematoma volume increased by approximately 28% from baseline to day 3 to 4, the relative edema volume almost doubled during this time period. We observed a significant positive correlation between serum ferritin and relative perihematoma edema volume on day 3 to 4 (r=0.78; P=0.002), but not at baseline; and little correlation between the changes in hematoma volumes and corresponding relative edema volumes (r=0.14). There was a trend for a positive correlation between body temperature and relative edema volumes.


CONCLUSIONS
Our findings support the notion that delayed iron toxicity plays a role in causing brain injury and edema formation after ICH. These findings are preliminary and need to be further investigated in future studies.
Mehdiratta
Manu
M
Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Mass. 02215, USA.
Kumar
Sandeep
S
Hackney
David
D
Schlaug
Gottfried
G
Selim
Magdy
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000097:blood* / Q000000981:diagnostic imaging*; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000000981:diagnostic imaging*; D005260:Female; D005293:Ferritins / Q000097:blood*; D005500:Follow-Up Studies; D006406:Hematoma / Q000097:blood / Q000000981:diagnostic imaging; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
D005293:Ferritins; D007501:Iron