Cerebrospinal fluid tenascin-C increases preceding the development of chronic shunt-dependent hydrocephalus after subarachnoid hemorrhage.
OBJECTIVE
The possible cause of chronic hydrocephalus after subarachnoid hemorrhage (SAH) has been reported to be meningeal fibrosis. We examined whether the induction of tenascin-C (TN-C), an extracellular matrix glycoprotein known to promote tissue fibrosis, was associated with chronic hydrocephalus after SAH.


METHODS
We prospectively measured cerebrospinal fluid TN-C levels in 7 control patients with unruptured cerebral aneurysms and in 29 consecutive patients with aneurysmal SAH on days 1 to 12.


RESULTS
Cerebrospinal fluid TN-C levels were less than the diagnostic threshold level in control patients but markedly increased after SAH. Higher TN-C levels were observed in patients with more severe SAH on admission CT, ventricular drainage for acute obstructive hydrocephalus, and a worse outcome. Independent of these factors, however, cerebrospinal fluid TN-C levels were significantly higher in patients with than without subsequent chronic shunt-dependent hydrocephalus on days 1 to 9.


CONCLUSIONS
These findings suggest the possible involvement of TN-C in the development of chronic hydrocephalus after SAH and encourage further studies.
Suzuki
Hidenori
H
Kinoshita
Noriaki
N
Imanaka-Yoshida
Kyoko
K
Yoshida
Toshimichi
T
Taki
Waro
W
D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000134:cerebrospinal fluid; D002557:Cerebrospinal Fluid Shunts; D002908:Chronic Disease / Q000628:therapy; D005109:Extracellular Matrix / Q000378:metabolism; D005260:Female; D005355:Fibrosis / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid* / Q000209:etiology* / Q000601:surgery; D008297:Male; D008578:Meninges / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D019063:Tenascin / Q000032:analysis / Q000134:cerebrospinal fluid*; D015854:Up-Regulation / Q000502:physiology
D015415:Biomarkers; D019063:Tenascin