gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Proenkephalin as marker for severity of aneurysmal subarachnoid hemorrhage: a pilot study

Meeting Abstract

  • Christian Fung - Abteilung für Neurochirurgie, Universitätsklinikum Bern, Schweiz
  • Gian Marco De Marchis - Abteilung für Neurologie, Universitätsklinikum Bern, Schweiz
  • Mira Katan - Department of Neurology, College of Physicians and Surgeons, Columbia University, New York
  • Christoph Ozdoba - Institut für diagnostische und interventionelle Neuroradiologie, Bern, Schweiz
  • Andreas Raabe - Abteilung für Neurochirurgie, Universitätsklinikum Bern, Schweiz
  • Jürgen Beck - Abteilung für Neurochirurgie, Universitätsklinikum Bern, Schweiz

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 156

doi: 10.3205/14dgnc550, urn:nbn:de:0183-14dgnc5504

Published: May 13, 2014

© 2014 Fung et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Several biomarker have shown associations with severity, vasospasm, ischemic events or outcome in aneurysmal subarachnoid hemorrhage. Yet no biomarker is used in daily clinical routine. Previously encephalin peptides were described as new biomarkers in ischemic stroke and traumatic brain injury. We sought to evaluate the usefulness of Proenkephalin A, a precursor protein of encephalin peptides, as biomarker in aneurysmal subarachnoid hemorrhage.

Method: Eighteen consecutive patients with aSAH had plasma PENK A levels measured with a validated chemiluminescence sandwich immunoassay. The association of PENK A levels at admission with severity of SAH according to the World Federation of Neurological Surgeons (WFNS) grade after resuscitation was the primary endpoint. Levels of PENK A are analyzed with respect to different clinical and radiological scores as well as between patients with ICH, intraventricular hemorrhage, hydrocephalus, brain edema, vasospasm and ischemia.

Results: Good grade patients showed median PENK A levels of 73.9pmol/l (IQR 69-80.4) and poor grade patients 117pmol/l (IQR 86-149). PENK A levels are significantly associated with severity of SAH as graded on the WFNS scale (p=0.03). No other parameter had a significant association.

Conclusions: PENK A might be a useful serum marker in aSAH. Yet, larger trials also with serial PENK A assessments are needed.