Document Detail

Axonal pathology in subarachnoid and intracerebral hemorrhage.
MedLine Citation:
PMID:  15785235     Owner:  NLM     Status:  MEDLINE    
Electrically active axons degenerate in the presence of nitric oxide (NO) in vitro. High CSF NO concentrations have been observed in patients with hemorrhagic brain injury such as subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH). This study investigated the evidence for axonal injury in SAH and ICH and related this to CSF NO levels. In this study, neurofilament phosphoforms (NfH(SMI34), NfH(SMI35), NfH(SMI38), NfH(SMI310)), surrogate markers for axonal injury, and NO metabolites (nitrate, nitrite = NOx) were measured by ELISA in cerebrospinal fluid (CSF) from patients with SAH and ICH and from a group of controls. Injury severity was classified using the Glasgow Coma Scale, and survival was used as the outcome measure. Compared to the control group, a higher proportion of patients with SAH and ICH had elevated NfH(SMI34) levels from day 0 to day 6 (p < 0.001), elevated NfH(SMI35) levels from day 1 to 6 (p < 0.001), and elevated NfH(SMI310) levels at day 0, 1, 4, and 6 (p < 0.001). The NOx levels were higher in the SAH and ICH patients than in the controls (p < 0.05) and distinguished the non-survivors from the survivors (p < 0.05). No direct correlation was found for NOx with any of the NfH phosphoforms. This study provides evidence for primary and secondary axonal injury in patients with SAH and ICH, with non-survivors also having higher NOx levels. CSF NfH phosphoforms might emerge as a putative surrogate marker for monitoring the development for secondary axonal degeneration in neurocritical care and guiding targeted neuroprotective strategies.
A Petzold; K Rejdak; A Belli; J Sen; G Keir; N Kitchen; M Smith; E J Thompson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurotrauma     Volume:  22     ISSN:  0897-7151     ISO Abbreviation:  J. Neurotrauma     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-23     Completed Date:  2005-06-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  407-14     Citation Subset:  IM    
Department of Neuroimmunology, Institute of Neurology, University College London, London, United Kingdom.
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MeSH Terms
Axons / pathology*
Cerebral Hemorrhage / cerebrospinal fluid*,  pathology*
Cohort Studies
Middle Aged
Neurofilament Proteins / cerebrospinal fluid
Nitric Oxide / cerebrospinal fluid
Prospective Studies
Subarachnoid Hemorrhage / cerebrospinal fluid*,  pathology*
Reg. No./Substance:
0/Neurofilament Proteins; 10102-43-9/Nitric Oxide

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