gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Correlation between increase of intrathecal Interleukine-6 and shunt-dependent posthemorrhagic hydrocephalus after aneurysmal subarachnoid hemorrhage

Meeting Abstract

  • M. Wostrack - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • A. Preuß - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • J. Martin - Klinik für Anästhesiologie, Klinikum rechts der Isar, Technische Universität München
  • F. Ringel - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • B. Meyer - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München
  • Y.M. Ryang - Neurochirurgische Klinik, Klinikum rechts der Isar, Technische Universität München

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.08.04

DOI: 10.3205/12dgnc229, URN: urn:nbn:de:0183-12dgnc2292

Published: June 4, 2012

© 2012 Wostrack et al.
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Outline

Text

Objective: Aneurysmal subarachnoid hemorrhage (SAH) is reported to induce an intrathecal inflammatory reaction with cytokine release, which correlates with early posthemorrhagic brain damage and poor clinical outcome. The role of inflammation is also linked to the development of hydrocephalus (HC) malresorptivus. Aim of this study was to examine whether the intrathecal increase of the major proinflammatory mediator Interleukine-6 (IL-6) within 14 days after SAH in patients with acute posthemorrhagic HC is associated with shunt-dependency.

Methods: 71 patients with acute SAH were admitted from June 2010 to September 2011 to our department. In patients, who received an external ventricular drainage due to acute posthemorrhagic HC, CSF concentrations of IL-6 were measured at regular intervals (every 2 or 3 days) until day 14. SAH patients in whom IL-6 values could not be determined regularly were excluded. 28 patients were included into the study. The maximum values of IL-6 of each patient within the first 14 days (IL-6max) after SAH was determined.

Results: In the 28 patients IL-6max ranged between 945 and 41412 pg/ml. 8 of 24 survivors underwent shunt surgery due to posthemorrhagic HC. According to the statistical classification tree predictive model with the best cut value of IL-6max determined at 10300 pg/ml, 75% of shunt dependency was observed in the group with IL-6max > 10300 vs. only 25% in the IL-6max ≤ 10300 group. Similar correlations between increased IL-6max values and clinically manifest vasospasms, cerebral infarction, poor outcome or mortality were not observed.

Conclusions: Increase of intrathecal IL-6 within the first 14 days after SAH to > 10 000 pg/ml was clearly associated with a higher incidence of posthemorrhagic shunt-dependent HC. CSF IL-6 may play a role as a predictive diagnostic factor for shunt-dependency after SAH. A larger study is needed to verify the significance level of this observation by means of regression analysis.