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C-reactive protein in intracerebral hemorrhage: Time course, tissue localization, and prognosis.
MedLine Citation:
PMID:  22855859     Owner:  NLM     Status:  Publisher    
OBJECTIVES:We examined the C-reactive protein (CRP) response after spontaneous intracerebral hemorrhage (sICH) and its relationship to outcome. We additionally characterized early brain localization of CRP. METHODS:In this prospective, multicenter, international, collaborative, longitudinal study with cross-sectional immunohistochemical analysis of brain tissue, 223 patients (M/F: 132/91) were recruited during the 2010 calendar year. CRP was evaluated at admission (median 93 minutes from symptom onset), 24 hours, 48 hours, and 72 hours after sICH. Brains of 5 subjects with sICH were compared to brains of 2 aged controls without evidence of brain pathology and 7 patients with ischemic stroke. Plasma CRP was measured over 72 hours following sICH and its relationship to 30-day mortality and functional outcome at 30 days (Glasgow Outcome Scale) was determined. CRP immunostaining patterns were analyzed in samples of sICH autopsy brains. RESULTS:Plasma CRP increased over the 48 hours from admission and was significantly (p < 0.001) related to hematoma volume at later time points. The predictive utility of CRP for morbidity and mortality were maintained when adjusted for other risk factors and improved at 48 hours and 72 hours when compared with admission values. Although an early CRP localization was present in both ischemic and hemorrhagic lesions, an intense and diffuse neuropil staining was only present in sICH patients and particularly evident proximal to the hemorrhagic areas. CONCLUSIONS:Plasma CRP production increases markedly over the 48 hours to 72 hours period following sICH and is related to outcome. CRP is also present in large amounts around the hemorrhagic lesion and within neurons and glia of patients who died within 12 hours of sICH.
Mario Di Napoli; Daniel Agustin Godoy; Veronica Campi; Luca Masotti; Craig J Smith; Adrian R Parry Jones; Stephen J Hopkins; Mark Slevin; Francesca Papa; Laurentiu Mogoanta; Daniel Pirici; Aurel Popa Wagner
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-1
Journal Detail:
Title:  Neurology     Volume:  -     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
From the Neurological Service (M.D.N.), San Camillo de Lellis General Hospital, Rieti; Neurological Section, SMDN-Center for Cardiovascular Medicine and Cerebrovascular Disease Prevention (M.D.N., F.P.), Sulmona, L'Aquila, Italy; Neurocritical Care Unit (D.A.G.) and Central Laboratory (V.C.), Sanatorio Pasteur, Catamarca, Argentina; Internal Medicine (L. Masotti), Cecina Hospital, Cecina, Italy; Brain Injury Research Group (C.J.S., A.R.P.J., S.J.H.), Clinical Sciences Building, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester; SBCHS (M.S.), John Dalton Building, Manchester Metropolitan University, Manchester, UK; Institut Català de Ciències Cardiovasculars Hospital de la Santa Creu i Sant Pau (M.S.), Pavelló del Convent Sant Antoni Maria Claret, Barcelona, Spain; Research Center for Microscopic Morphology and Immunology & Biochemistry (L. Mogoanta, D.P., A.P.W.), University of Medicine and Pharmacy of Craiova, Romania; and Department of Psychiatry, Molecular Psychiatry (A.P.W.), Rostock Medical School of Medicine, Germany.
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