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Serum glial fibrillary acidic protein is related to focal brain injury and outcome after aneurysmal subarachnoid hemorrhage.

Artikel i vetenskaplig tidskrift
Författare Karin Nylén
Ludvig Z Csajbok
Martin Öst
Moheb A. Rashid
Kaj Blennow
Bengt Nellgård
Lars Rosengren
Publicerad i Stroke
Volym 38
Nummer/häfte 5
Sidor 1489-94
ISSN 1524-4628
Publiceringsår 2007
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi
Institutionen för kliniska vetenskaper
Sidor 1489-94
Språk en
Länkar dx.doi.org/10.1161/STROKEAHA.106.47...
Ämnesord Adult, Aged, Aged, 80 and over, Biological Markers, blood, Brain Injuries, blood, etiology, Female, Glial Fibrillary Acidic Protein, blood, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Prognosis, Subarachnoid Hemorrhage, blood, complications
Ämneskategorier Medicin och Hälsovetenskap, Neurokirurgi

Sammanfattning

BACKGROUND AND PURPOSE: Aneurysmal subarachnoid hemorrhage (aSAH) stands out from other subtypes of stroke because of the high early mortality and the risk of complications. Serum glial fibrillary acidic protein (s-GFAP) concentrations are increased after stroke. The aim of this study was to investigate whether s-GFAP could be used as a marker of brain damage and outcome after aSAH. METHODS: Serum samples were obtained on a regular basis from 116 adults during a 2-week period after aSAH and analyzed using an enzyme-linked immunosorbent assay. The World Federation of Neurological Surgeons scale was used for neurological evaluation. Outcome was assessed after 1 year and categorized according to the Extended Glasgow Outcome Scale. RESULTS: Increased s-GFAP levels were seen in 81 of the 116 patients. Maximum s-GFAP correlated with World Federation of Neurological Surgeons scale on arrival and on days 10 to 15 (r=0.37, P<0.001 and r=0.47, P<0.001, respectively). Furthermore, maximum s-GFAP levels were increased in the patient group with radiological signs of focal lesions acute or at 1 year, compared with the group without focal lesions (P<0.001 in both comparisons). Patients with secondary events (re-bleeding or ischemia) reached maximum levels later in the series and both maximum and final s-GFAP levels increased compared with the levels in patients without secondary events (P<0.001 in all 3 comparisons). Finally, maximum s-GFAP correlated with outcome (r=-0.48, P<0.001) and s-GFAP was an independent predictor of dichotomized outcome. CONCLUSIONS: s-GFAP provides information about brain injury severity and outcome after aSAH, which can be useful as a complement to clinical data.

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