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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Ferritin in Cerebrospinal Fluid and Serum as a Predictive Marker for the Development of ischemic Brain Infarction after Subarachoidal Hemorrhage

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  • Katharina Graf - Gießen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.11.03

doi: 10.3205/17dgnc430, urn:nbn:de:0183-17dgnc4305

Published: June 9, 2017

© 2017 Graf.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Our study investigates the relation of the mean quotient of ferritin in CSF and serum to ischemic brain infarction in SAH patients.

Methods: Prospective study including patients with aneurysmal SAH (modified Fisher Grade 4: 90% and modified Fisher Grade 2: 10%) and early aneurysm obliteration (first 72h) . The ferritin levels in the cerebrospinal fluid (CSF) and serum were measured daily over two weeks after hemorrhage (CSF/Serum ratio). Ischemic brain infarction was evaluated by computertomography 14 days after hemorrhage. Statistical significance between patients with and without infarction was calculated using the Mann-Whitney-U-test.

Results: So far 20 patients (7 male, 13 female) with a median age of 58 could be included. In 5/20 patients an ischemic brain infarction was observed. Initial serum and CSF ferritin concentrations were 252±284 ng/ml (mean±SD) and 109±70 ng/ml in patients with brain infarction and 195±162 ng/ml and 451±770 ng/ml in patients without brain infarction. During acute care the mean ferritin concentration in serum and CSF increased over time and reached a maximum plateau between day 8 to 11 with a mean serum concentration of 577±719 ng/ml and a mean CSF concentration of 2838±3518 ng/ml in patients with brain infarction and of 341±250 ng/ml and 18340±1632 ng/ml in patients without brain infarction. Furthermore, the ratio of mean serum and CSF concentration was significantly increased in patients with brain infarction (13.5) compared to patients without brain infarction (6.8, p<0.01).

Conclusion: The ferritin CSF/Serum ratio seems to be a predictive marker for the development of ischemic brain infarction after SAH. However, these results need further evaluation in a larger cohort.