title: TNF-alpha and sICAM-1 in intracranial aneurismal rupture.
abstract: BACKGROUND
  Subarachnoidal hemorrhage (SAH) occurring after aneurysmal rupture produces an inflammatory response in the cerebral circulation. Tumor necrosis factor (TNF)-alpha is a major cytokine in this process. Adhesion molecules provide information on inflammatory reactions taking place in the walls of blood vessels. Clinical evidence suggests a role of soluble intercellular adhesion molecule (sICAM)-1 in early hemorrhagic events. This study aimed to evaluate the implementation of early TNF-alpha and sICAM-1 serum measurement for the prognosis of patient outcome after intracranial aneurysmal rupture.
  
  
  METHODS
  The study consisted of 27 patients with a diagnosis of intracranial aneurysm. SAH was evaluated on admission according to the Fisher scale, patients' consciousness with the Glasgow Coma Scale, clinical grading with the Hunt and Hess scale, and clinical outcome with the Glasgow Outcome Scale (GOS). Blood samples were drawn within 72 h after arrival at the emergency room. Serum concentrations of TNF-alpha and sICAM-1 were assayed with the ELISA method.
  
  
  RESULTS
  The initial serum TNF-alpha concentration in the aneurysmal patients was low and did not correlate with radiological and clinical scores. The serum sICAM-1 level positively correlated with the severity of bleeding assessed by the Fisher scale and negatively with the patient's scoring in the GOS.
  
  
  CONCLUSIONS
  This study demonstrated the absence of a systemic TNF-alpha-mediated inflammatory response at the onset of subarachnoid hemorrhage. Early measurement of serum sICAM-1 levels offers a potential prognostic value in the assessment of patients' outcome after brain aneurysmal rupture.
authors.affiliation: Department of Food Commodities Science and Technology, Medical University, Mieszka I4b, Białystok, Poland. witam@umwb.edu.pl
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Witkowska
authors.forename: Maria Halina
authors.initials: MH
authors.lastname: Borawska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Socha
authors.forename: Jan
authors.initials: J
authors.lastname: Kochanowicz
authors.forename: Zenon
authors.initials: Z
authors.lastname: Mariak
authors.forename: Maria
authors.initials: M
authors.lastname: Konopka