Relationship between leukocytosis and ischemic complications following aneurysmal subarachnoid hemorrhage

Spallone, A; Acqui, Michele; Pastore, Francesco Saverio; Guidetti, B

doi:10.1016/0090-3019(87)90038-3

Cited by 67 publications

(36 citation statements)

References 19 publications

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“…Release of vasoconstricting substances from the subarachnoid clot or the arterial wall acutely after SAH may contribute. [25][26][27][28][29] In addition, experimental studies suggest that EVSP may be accompanied by microcirculatory abnormalities. 30 -32 The acute vasospasm documented in animal studies occurs often within minutes to hours of subarachnoid blood release.…”

Section: Discussionmentioning

confidence: 99%

Early Vasospasm on Admission Angiography in Patients with Aneurysmal Subarachnoid Hemorrhage Is a Predictor for In-Hospital Complications and Poor Outcome

Baldwin

Macdonald

Huo

et al. 2004

Stroke

116

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Background and Purpose-Early vasospasm (EVSP), defined here as arterial narrowing seen on diagnostic angiography within the first 48 hours of aneurysmal rupture, is a rarely reported and poorly defined phenomenon in patients with subarachnoid hemorrhage (SAH). The purpose of this study was to characterize EVSP in a large database of such patients. Methods-We analyzed the relationship of EVSP to clinical characteristics, in-hospital complications, and outcome at 3 months among 3478 patients entered into 4 prospective, randomized, double-blind, placebo-controlled trials of tirilazad conducted in neurosurgical centers around the world between 1991 and 1997.

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Section: Discussionmentioning

confidence: 99%

Early Vasospasm on Admission Angiography in Patients with Aneurysmal Subarachnoid Hemorrhage Is a Predictor for In-Hospital Complications and Poor Outcome

Baldwin

Macdonald

Huo

et al. 2004

Stroke

116

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“…11,18,19 Systemic IL-6 might originate from the central nervous system and/or reflect the systemic inflammatory response. Although the prognostic significance of systemic leukocytosis for the outcome of patients with SAH has been recognized earlier, 16,17 the positive relationship between systemic inflammatory response, occurrence of CVS and subsequent worse outcome is a newer observation. 14,15 Taken abovementioned facts into account, systemic IL-6 levels might reflect the severity of illness and the risk of CVS development to a certain extent.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 The possible significance of systemic leukocyte count has been discussed earlier. 16,17 Less has been reported on systemic IL-6 levels, however, increased levels were described. 11,18,19 Systemic IL-6 might originate from the central nervous system and/or reflect the systemic inflammatory response.…”

Section: Introductionmentioning

confidence: 99%

Systemic interleukin-6 concentrations in patients with perimesencephalic non-aneurysmal subarachnoid hemorrhage

Muroi

Bellut

Coluccia

et al. 2011

Journal of Clinical Neuroscience

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Patients with spontaneous non-aneurysmal subarachnoid hemorrhage (non-aSAH) are considered to have a benign illness in contrast to patients with aSAH. The occurrence of the systemic inflammatory response syndrome has been linked to worse outcomes in patients with aSAH. We analyzed systemic interleukin (IL)-6, a proinflammatory cytokine, to determine whether its concentration differs between patients with non-aSAH and those with aSAH, reflecting the more benign illness. Daily systemic IL-6 levels were measured in the acute phase in 11 patients with non-aneurysmal perimesencephalic SAH (pmSAH), with bleeding strictly located around the midbrain, and in nine patients with non-aneurysmal non-perimesencephalic (non-pmSAH), with hemorrhage extending into adjacent cisterns (group 1). IL-6 levels were compared with those from patients suffering from aSAH with cerebral vasospasm (CVS) (group 2) and without CVS (group 3). The mean IL-6 level (±standard error of the mean) was significantly lower in group 1 compared to group 2 (9.9±1.9 vs. 29.1±6.7pg/mL, p=0.018). The difference in mean IL-6 level between group 1 and 3 fell short of significance (9.9±1.9 vs. 14.9±1.1pg/mL, p=0.073). Patients in group 1 had a significantly better outcome (Glasgow Outcome Scale score 4-5) compared to group 2 (p<0.001) and a trend towards better outcome compared to group 3 (p=0.102). A subgroup analysis revealed a higher mean IL-6 concentration in patients with non-pmSAH compared to patients with pm-SAH (p=0.001). We concluded that systemic IL-6 concentration reflects the severity of the inflammatory stress response and course of the illness. The more benign illness and good prognosis of patients with pmSAH or non-pmSAH in contrast to patients with aSAH is reflected by the lower concentrations of IL-6.

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“…The rationale for this approach is that acute subarachnoid and intracerebral hemorrhages cause acute elevations in circulating leukocytes, especially neutrophils. [27][28][29] …”

Section: Whole Blood and Blood Component Separationmentioning

confidence: 99%

Intracortical Hemorrhage Injury in Rats

Xue

Bigio

2000

Stroke

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Background and Purpose-Intracerebral hemorrhage is associated with stroke and head trauma. The purposes of this study were to investigate the effect of intracortical injections of autologous whole blood and blood components on inflammatory cell infiltration and brain cell death and to determine if nonhemorrhagic lesions differ in these respects. Methods-Eighty-seven adult rats were subjected to intracortical injections of autologous whole blood or allogeneic plasma, erythrocytes, leukocytes, "activated" leukocytes, and serum. Injections of saline or mineral oil were controls. Blood injections were compared with cortical freeze injury and pial devascularization. Rats were perfusion-fixed 48 hours after injection or lesioning. Eosinophilic neurons, TUNEL-positive cells, brain damage area, infiltrating neutrophils, and CD8a-immunoreactive lymphocytes were quantified. Results-Damage area, dying cells, and inflammatory infiltrate were significantly greater after autologous whole blood, leukocyte, and "activated" leukocyte injections than injection of other fractions. Conclusions-These results suggest that extravasated whole blood causes a greater degree of cortical cell death and inflammation than ischemic lesions of similar size. Leukocytes "activated" by systemic illness might exacerbate the injury. Secondary hemorrhagic phenomena suggest that the harmful effect is directed toward both brain cells and the vasculature. Further studies are required to delineate the mechanism(s).

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Relationship between leukocytosis and ischemic complications following aneurysmal subarachnoid hemorrhage

Cited by 67 publications

References 19 publications

Early Vasospasm on Admission Angiography in Patients with Aneurysmal Subarachnoid Hemorrhage Is a Predictor for In-Hospital Complications and Poor Outcome

Early Vasospasm on Admission Angiography in Patients with Aneurysmal Subarachnoid Hemorrhage Is a Predictor for In-Hospital Complications and Poor Outcome

Systemic interleukin-6 concentrations in patients with perimesencephalic non-aneurysmal subarachnoid hemorrhage

Intracortical Hemorrhage Injury in Rats

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