Intracerebral Iron Accumulation may be Associated with Secondary Brain Injury in Patients with Poor Grade Subarachnoid Hemorrhage

• DOI: 10.1007/s12028-021-01278-1
• Publication Date: 2021-08-09T18:25:01Z
• Authors: Raimund Helbok; Verena Rass; Mario Kofler; Heribert Talasz; Alois Schiefecker; Max Gaasch; Christoph Scherfler; Bettina Pfausler; Claudius Thomé; Ronny Beer; Herbert H. Lindner; Erich Schmutzhard
• Keywords: Interquartile range; Cerebral Vasospasm; Glasgow Outcome Scale

The amount of intracranial blood is a strong predictor poor outcome after subarachnoid hemorrhage (SAH). Here, we aimed to measure iron concentrations in the cerebral white matter, using microdialysis (CMD) technique, and associate levels with local metabolic profile, complications, functional outcome.For observational cohort study, 36 patients consecutive grade SAH (Hunt & Hess 4 or 5, Glasgow Coma Scale Score ≤ 8) undergoing multimodal neuromonitoring were analyzed for brain changes, including CMD quantified by graphite furnace atomic absorption spectrometry. study time encompassed 14 days admission. Statistical analysis was performed generalized estimating equations.Patients admitted clinical (n = 26, 72%) deteriorated within 24 h 10, 28%). median volume space high (SAH sum score interquartile range 20-28). Initial 44 µg/L (25-65 µg/L), which significantly decreased level 25 (14-30 µg/L) at day then constantly increased over remaining (p < 0.01). A higher intraventricular (≥ 5) associated (Wald-statistic 4.1, df 1, p 0.04) but not load 0.8). In developing vasospasm, higher, compared without vasospasm degree freedom 0.04), true delayed infarction 0.4). Higher extracellular fluid (34 µg/L, 36-56 vs. 23 15-37 mitochondrial dysfunction (CMD lactate pyruvate ratio > 30 CMD-pyruvate 70 µM/L, 0.001). Brain 3 months 0.5).This suggests that accumulates matter SAH. These findings may support trials aiming scavenger based on hypothesis iron-mediated neurotoxicity contribute acute secondary injury following