title: Heart-fatty acid-binding and tau proteins relate to brain injury severity and long-term outcome in subarachnoid haemorrhage patients.
abstract: BACKGROUND
  Vasospasm and other secondary neurological insults may follow subarachnoid haemorrhage (SAH). Biomarkers have the potential to stratify patient risk and perhaps serve as an early warning sign of delayed ischaemic injury.
  
  
  METHODS
  Serial cerebrospinal fluid (CSF) samples were collected from 38 consecutive patients with aneurysmal SAH admitted to the neurosurgical intensive care unit. We measured heart-fatty acid-binding protein (H-FABP) and tau protein (τ) levels in the CSF to evaluate their association with brain damage, and their potential as predictors of the long-term outcome. H-FABP and τ were analysed in relation to acute clinical status, assessed by the World Federation of Neurological Surgeons (WFNS) scale, radiological findings, clinical vasospasm, and 6-month outcome.
  
  
  RESULTS
  H-FABP and τ increased after SAH. H-FABP and τ were higher in patients in poor clinical status on admission (WFNS 4-5) compared with milder patients (WFNS 1-3). Elevated H-FABP and τ levels were also observed in patients with early cerebral ischaemia, defined as a CT scan hypodense lesion visible within the first 3 days after SAH. After the acute phase, H-FABP, and τ showed a delayed increase with the occurrence of clinical vasospasm. Finally, patients with the unfavourable outcome (death, vegetative state, or severe disability) had higher peak levels of both proteins compared with patients with good recovery or moderate disability.
  
  
  CONCLUSIONS
  H-FABP and τ show promise as biomarkers of brain injury after SAH. They may help to identify the occurrence of vasospasm and predict the long-term outcome.
authors: IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Department of Neuroscience, Via G. La Masa 19, 20156 Milan, Italy. elisa.zanier@marionegri.it
authors: E R
authors: ER
authors: Zanier
authors: T
authors: T
authors: Zoerle
authors: M
authors: M
authors: Fiorini
authors: L
authors: L
authors: Longhi
authors: L
authors: L
authors: Cracco
authors: A
authors: A
authors: Bersano
authors: V
authors: V
authors: Branca
authors: M D
authors: MD
authors: Benedetti
authors: M G
authors: MG
authors: De Simoni
authors: S
authors: S
authors: Monaco
authors: N
authors: N
authors: Stocchetti
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001930:Brain Injuries / Q000134:cerebrospinal fluid*; D050556:Fatty Acid-Binding Proteins / Q000134:cerebrospinal fluid*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid*; D016896:Treatment Outcome; D016875:tau Proteins / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D016875:tau Proteins
keywords: H-FABP; brain injury; cerebral vasospasm; subarachnoid haemorrhage; τ protein