gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Blood glucose level, glycated hemoglobin and cerebral perfusion early after aneurysmal subarachnoid hemorrhage

Meeting Abstract

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  • Kerim Beseoglu - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Düsseldorf, Germany
  • Hans-Jakob Steiger - Neurochirurgische Klinik, Heinrich-Heine-Universität Düsseldorf, Medizinische Fakultät, Düsseldorf, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.02.05

doi: 10.3205/16dgnc095, urn:nbn:de:0183-16dgnc0953

Published: June 8, 2016

© 2016 Beseoglu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: Elevated blood glucose is frequently detected early after aneurysmal subarachnoid hemorrhage (aSAH) and is considered a risk factor for poor neurological outcome. However it remains unclear whether hyperglycemia is a metabolic response to early brain injury or reflects a pre-existing hyperglycemic metabolism and if an influence on cerebral brain perfusion exists. In this analysis, levels of blood glucose, glycated hemoglobin (HbA1c) and cerebral perfusion as measured by perfusion computed tomography (PCT) were correlated to identify a possible impact on patient outcome.

Method: Prospectively, 90 patients with confirmed aSAH were included between July 2012 and July 2014. Upon admission HbA1c as a measure for elevated blood glucose levels in the weeks preceding aSAH and blood glucose levels along with epidemiological data were recorded. PCT was obtained within 12 hours after admission and before obliteration of the aneurysm. Patient outcome was recorded after 6 month using modified Rankin scale (mRS). Statistical analysis included correlation analysis of blood glucose level with initial neurological status, HbA1c and early PCTas well as uni- and multivariate analysis of its impact on outcome.

Results: Initial blood glucose level correlated significantly with neurological status at admission (p=0.030, r=0.396) independent of HbA1c level (p=0.114). HbA1c level did not correlate with initial neurological status (p=0.984, r=-0.004) or the amount of subarachnoid blood (Fisher grade, p=0.322, r=0.187) and failed to show a significant influence on the occurrence of delayed cerebral ischemia (DCI) (p=0.791) or outcome after 6 month (p=0.374). Early PCT impairment showed a trend towards worse outcome (p=0.088), however, it did not correlate with occurrence of DCI (p=0.707). Furthermore, impaired PCT did not correlate with elevated blood glucose levels (p=0.341).

Conclusions: Initially elevated blood glucose levels correlate with poor patient outcome independent of cerebral perfusion as measured by PCT, suggesting different pathways of brain injury. A pre-existing hyperglycemic metabolism, as reflected by elevated HbA1c levels, is not a relevant contributor to the impact of SAH or influences the quality of neurological recovery.