title: The association between symptomatic delayed cerebral infarction and serum adhesion molecules in aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Serum concentrations of adhesion molecules may be connected to the pathogenesis of delayed cerebral infarction (DCI) after aneurysmal subarachnoid hemorrhage (SAH).
  
  
  OBJECTIVE
  To test the hypothesis that levels of adhesion molecules are substantially increased after DCI and decreased thereafter and that these levels can predict treatment outcomes.
  
  
  METHODS
  Serial circulating markers of adhesion molecules were examined in 21 consecutive SAH patients and 2 risk control subjects. All underwent cerebral angiography and magnetic resonance imaging to confirm the DCI. The timing of magnetic resonance imaging was fixed in the acute phase and before hospital discharge.
  
  
  RESULTS
  Symptomatic DCI developed in 33% of the patients (7 of 21). Statistical analysis of levels of adhesion molecules between patients with and those without DCI revealed that soluble (s) L-selectin, sP-selectin, and sE-selectin concentrations significantly increased after symptomatic DCI (P=.003, .013, and .043, respectively). Only higher sL-selectin level on presentation (cutoff value > 636 ng/mL) was significantly associated with poor outcome after 6 months of follow-up.
  
  
  CONCLUSIONS
  Increased sL-selectin, sP-selectin, and sE-selectin levels imply risks of symptomatic DCI after aneurysmal SAH. The high frequency of symptomatic DCI and higher sL-selectin level on presentation may be associated with worse outcomes.
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College Hospital of Medicine, Kaohsiung, Taiwan.
authors.forename: Hung-Chen
authors.initials: HC
authors.lastname: Wang
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lin
authors.forename: Tzu-Ming
authors.initials: TM
authors.lastname: Yang
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Lin
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.forename: Kuei-Yueh
authors.initials: KY
authors.lastname: Cheng
authors.forename: Jih-Tsun
authors.initials: JT
authors.lastname: Ho
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002544:Cerebral Infarction / Q000097:blood* / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D019087:Selectins / Q000097:blood*; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000150:complications; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D019087:Selectins