Biochemical markers for blood-brain barrier dysfunction in acute ischemic stroke correlate with evolution and outcome.
OBJECTIVE
We evaluated the cerebrospinal fluid/serum albumin ratio (AR) and kinetics of matrix metalloproteinase-9 (MMP-9) in blood as markers for blood-brain barrier (BBB) disruption after acute ischemic stroke.


METHODS
The AR was determined in 88 patients with acute ischemic stroke or transient ischemic attack. MMP-9 was measured on admission, 24, 72 h and 7 days after stroke onset.


RESULTS
The AR was related to stroke severity, the occurrence of stroke progression and the modified Rankin Scale score at month 3. MMP-9 levels on admission were significantly elevated compared to controls and dropped in the first 72 h after stroke, except in patients with stroke progression and larger infarcts in the subacute phase.


CONCLUSIONS
We demonstrate that the extent of BBB breakdown in hyperacute stroke relates to initial stroke severity, stroke evolution and long-term outcome. The kinetics of MMP-9 confirm its pivotal role in secondary brain damage after ischemic stroke.
Department of Neurology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Raf
R
Brouns
Annick
A
Wauters
Didier
D
De Surgeloose
Peter
P
Mariën
Peter P
PP
De Deyn
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001812:Blood-Brain Barrier / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D012709:Serum Albumin / Q000032:analysis; D020521:Stroke / Q000097:blood* / Q000473:pathology*; D016896:Treatment Outcome
D015415:Biomarkers; D012709:Serum Albumin; D020780:Matrix Metalloproteinase 9