gms | German Medical Science

Objective: Quantitative changes of serum levels of S100B and neuron specific enolase (NSE) are able to reflect the extent of ischemic stroke (Whiteley 2008). Intracranial aneurysm treatment might be associated with temporary or permanent ischemia. The goal of this study is to clarify whether serum levels of S100B and NSE are able to monitor ischemic damage occurring during aneurysm treatment.

Method: Prospective exploratory study in a cerebrovascular referral center. Patients with surgically treated intracranial aneurysm were prospectively included. Entry variables included demographic data, location of aneurysm, subarachnoid hemorrhage yes/no, intrainterventional ischemic events (type and duration). Serum levels of S100 (A1B and BB) and NSE were determined in ug/l preoperatively and on postoperative days one to five. Postoperative MR imaging with DWI and FLAIR sequences within the first 48 hours was screened for signs of recent ischemia. Maximal difference of pre-interventional versus postinterventional (preop-postop) serum values and the area under curve (AUC) were compared between patients who sustained an intrainterventional ischemia (group M, “mit”) and those who did not (group 0, “ohne”) using standard parametric statistical tests. Significance was set at P<0.05.

Results: N =8 (5 females, mean age 61 years, range 44 to 73 years) were included until submission deadline of this abstract. There were 5 MCA, 2 AComA and one ICA aneurysms. Two patients suffered a subarachnoid hemorrhage (Hunt and Hess III and V, respectively). In n=3 patients temporary clipping of the afferent vessel was necessary. The maximal preop-postop difference of S100 B was 0.0268 (mean, SD 0.0227) in group 0 and 0.037 (mean, SD 0.211) in group M (Δ=0.029, P=0.75), the AUC was 8.060 (mean, SD 1.594) in group 0 and 14.924 (mean, SD 7.022) in group M (Δ=6.863, P=0.069). The maximal preop-postop difference of NSE was 2.16 (mean, SD 6.04) in group 0 and -0.07 (mean, SD 2.74) in group M (Δ=2.286, P=0.57); the AUC was 1667.64 (mean, SD 326.30) in group 0 and 1495.8 (mean, SD 477.47) in group M (Δ=–171.84, P=0.56).

Conclusions: The determination of the area under curve (AUC) of post-interventional serum levels of S100B might provide quantitative data for the monitoring of peri-interventional ischemia during the treatment of intracranial aneurysms. These data need further validation in a larger series.