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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Altered CSF metabolomics after aneurysmal SAH and clinical outcome

Liquor Metaboliten nach aneurysmatischer Subarachnoidalblutung und klinisches Outcome

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Wing Mann Ho - Medizin Uniklinik Innsbruck, Neurochirurgie, Innsbruck, Austria
  • Alice Görke - Medizin Uniklinik Innsbruck, Neurochirurgie, Innsbruck, Austria
  • Selma Tülü - Medizin Uniklinik Innsbruck, Neurochirurgie, Innsbruck, Austria
  • Claudia Unterhofer - Medizin Uniklinik Innsbruck, Neurochirurgie, Innsbruck, Austria
  • Raimund Helbok - Medizin Uniklinik Innsbruck, Neurologie, Innsbruck, Austria
  • Herbert Oberacher - Medizin Uniklinik Innsbruck, Gerichtsmedizin, Innsbruck, Austria
  • Claudius Thomé - Medizin Uniklinik Innsbruck, Neurochirurgie, Innsbruck, Austria
  • presenting/speaker Ondra Petr - Medizin Uniklinik Innsbruck, Neurochirurgie, Innsbruck, Austria

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocP017

doi: 10.3205/19dgnc355, urn:nbn:de:0183-19dgnc3555

Veröffentlicht: 8. Mai 2019

© 2019 Ho et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: The aim of this study was to investigate metabolite levels in cerebrospinal fluid (CSF) after aneurysmal subarachnoid hemorrhage (aSAH) and their correlation with clinical outcome.

Methods: Eighty CSF samples of 16 patients with treated intracranial aneurysms were analyzed. The study population included patients undergoing emergency endovascular/microsurgical treatment for ruptured intracranial aneurysms (n=8). Control samples were collected intraoperatively during elective aneurysm surgery (n=8). The CSF samples after aSAH were consecutively collected via external ventricular drain (EVD) placement/intraoperatively, 6 hours later, and daily thereafter (day 1-10). The endogenous metabolites were analyzed with a targeted quantitative and quality controlled metabolomics approach using the Absolute IDQ® p180 Kit. Clinical outcome at discharge and follow-up of 6 months was assessed using the modified Rankin Scale (mRS) and divided into favorable (mRS 0-1) and unfavorable outcome (mRS 2-5).

Results: Several amino acid (AA) levels were increased in the CSF of patients with unfavorable outcome (n=4) compared to the group with elective aneurysm surgery (n=8, p<0.05) and favorable outcome (n=4; p<0.05). Elevated concentrations of asparagin, citrulline, glycine, histidin, isoleucine, leucine, lysine, phenylalanine, proline, ornithine, valine, kynurenine, symmetric dimethylarginine and asymmetric dimethylarginine were associated with poor outcome (p<0.05). Additionally, elevation of glucogenic AA concentration strongly correlated with aSAH and unfavorable outcome (p=0.02). The level of branched-chain AA was higher in aSAH-patients compared to controls (p<0.05). The ratio of ornithine/arginine and citrulline/arginine were increased in aSAH patients with poor outcome (p<0.01). Several phosphatidylcholine and sphingomyelin concentrations were increased after aSAH and associated with unfavorable outcome.

Conclusion: Numerous significantly elevated CSF-metabolites/compounds were found in patients with unfavorable outcome (mRS 2-5). Their value as potential biomarkers deserves further investigation.