gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Increases in Neuropeptide Y in serum following clipping of anterior circulation aneurysms

Meeting Abstract

  • K.M. Schebesch - Department of Neurosurgery, Medical Center, University of Regensburg
  • S. Bele - Department of Neurosurgery, Medical Center, University of Regensburg
  • S. Kagerbauer - Department of Anesthesiology, Medical Center, Technical University of Munich
  • A. Brawanski - Department of Neurosurgery, Medical Center, University of Regensburg
  • M. Proescholdt - Department of Neurosurgery, Medical Center, University of Regensburg

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 045

DOI: 10.3205/11dgnc266, URN: urn:nbn:de:0183-11dgnc2664

Published: April 28, 2011

© 2011 Schebesch et al.
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Outline

Text

Objective: The neurotransmitter polypeptide Neuropeptide Y (NPY) is a potent vasoconstrictor; its role in the pathophysiology of spontaneous subarachnoid hemorrhage (SAH) has not yet been sufficiently yet. Recently, we reported on the correlation between NPY in CSF with vasospasm and outcome in 37 patients with spontaneous SAH. Here, we present the evaluation of the serum levels of NPY in this cohort and correlate the results to the clinical course and to the type of aneurysm treatment (clip or coil).

Methods: Thirty-seven patients with SAH were included and compared to a healthy control group (27 patients). Twenty-one patients met the doppler-sonography criteria for vasospasm and eighteen of these patients developed a stroke. In eighteen patients a craniotomy and clipping procedure were performed; in 14 patients the aneurysm was occluded with coils. All patients had an arterial catheter in the radial artery and blood was drawn daily for NPY analysis over a ten-day interval.

Results: The levels of NPY in serum were significantly higher after SAH than in the control group (p=0.001). The levels of NPY ranged significantly higher in patients with craniotomy and clipping than in the coiling group from days 3 to 10 (p=0.001). In fact, on day 1, we found a statistically significantly higher level of NPY in the serum of the 18 patients with vasospasm-related stroke over the time course of ten days (p=0.001).

Conclusions: We presume that retraction of the forebrain, opening of the Sylvian fissure and preparation of the aneurysm lead to excessive release of NPY in the systemic circulation. Furthermore, our data support the theory that NPY is increasingly due to vasospasm-related stroke after SAH. We suggest that NPY plays a major role in the pathophysiology of SAH.