title: Tenascin-C is a possible mediator between initial brain injury and vasospasm-related and -unrelated delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Tenascin-C (TNC), a matricellular protein, exerts diverse functions, including tissue remodeling and apoptosis, and is induced in cerebrospinal fluid (CSF) after aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to examine the relationships among CSF TNC levels, initial brain injury, delayed cerebral ischemia (DCI), and vasospasm after SAH.
  
  
  METHODS
  CSF TNC levels were measured in 30 patients with aneurysmal SAH of Fisher computed tomography (CT) group III who were treated microsurgically or endovascularly with CSF drainage within 24 h of SAH. Admission World Federation of Neurosurgical Societies (WFNS) grade was supposed to indicate the severity of initial brain injury. Cerebral vasospasm was defined as narrowed (≥ 25 %) cerebral arteries demonstrated by angiography. DCI was defined as any neurological deterioration presumed related to ischemia that persisted for ≥ 1 h.
  
  
  RESULTS
  Higher CSF TNC levels were correlated with worse admission WFNS grades. Vasospasm was aggravated with higher TNC levels. DCI occurred regardless of the degree of vasospasm but was associated with TNC induction. Multivariate analyses showed that higher TNC levels and vasospasm were independent predictors of DCI occurrence.
  
  
  CONCLUSIONS
  SAH (initial brain injury) that is more severe induces more TNC, which may cause the subsequent development of both vasospasm and vasospasm-unrelated secondary brain injury, leading to DCI.
authors.affiliation: Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, 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: Fumio
authors.initials: F
authors.lastname: Kawakita
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; D001930:Brain Injuries / Q000134:cerebrospinal fluid* / Q000209:etiology; D002545:Brain Ischemia / Q000134:cerebrospinal fluid* / Q000209:etiology; D005109:Extracellular Matrix / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000150:complications; D019063:Tenascin / Q000134:cerebrospinal fluid*; D020301:Vasospasm, Intracranial / Q000134:cerebrospinal fluid* / Q000209:etiology
chemical_list: D019063:Tenascin