title: Cerebrospinal fluid tenascin-C in cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Tenascin-C (TNC) has been reported to be a useful biomarker for the activity of inflammatory diseases. This study investigated the association between TNC levels in the cerebrospinal fluid (CSF) and symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH), and the prognostic value of TNC levels.
  
  
  METHODS
  TNC levels were measured in CSF in 33 consecutive patients diagnosed with aneurysmal SAH of Fisher computed tomography group III and were compared between those with and without subsequent cerebral vasospasm. Factors influencing symptomatic vasospasm were determined using multivariate logistic regression analyses. The receiver-operating characteristic curve technique was used to assess specificity and sensitivity in the prediction of symptomatic vasospasm.
  
  
  RESULTS
  The CSF TNC levels peaked immediately after SAH and were significantly higher in patients who subsequently developed symptomatic vasospasm than in those who did not. On multivariate analyses, higher TNC levels in the CSF (odds ratio, 1.059; 95% confidence interval, 1.023-1.096; P<0.001) and World Federation of Neurosurgical Societies grades IV to V on admission (odds ratio, 3.238; 95% confidence interval, 1.033-10.152; P<0.05) significantly predicted symptomatic vasospasm. To predict the onset of symptomatic vasospasm, 16.2 ng/mL was considered as an appropriate cut-off value for CSF TNC on days 1 through 6, giving a sensitivity of 81.0% and a specificity of 79.5% (negative and positive predictive values: 82.3% and 76.7%, respectively).
  
  
  CONCLUSIONS
  TNC in the CSF may be a useful biomarker for predicting subsequent development of cerebral vasospasm.
authors.affiliation: Department of Neurosurgery, Mie University Graduate School of Medicine, Suzuka, Japan. suzuki02@clin.medic.mie-u.ac.jp
authors.forename: Hidenori
authors.initials: H
authors.lastname: Suzuki
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanamaru
authors.forename: Masato
authors.initials: M
authors.lastname: Shiba
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Kyoko
authors.initials: K
authors.lastname: Imanaka-Yoshida
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Waro
authors.initials: W
authors.lastname: Taki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000601:surgery; D013525:Surgical Instruments; D019063:Tenascin / Q000134:cerebrospinal fluid*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D019063:Tenascin