Turkish Neurosurgery 2014 , Vol 24 , Num 5
Analysis of the Serum Components in Acute Period After Subarachnoid Hemorrhage
Tomasz TYKOCKI1, Kacper KOSTYRA2, Krzysztof BOJANOWSKI2, Bogusław KOSTKIEWICZ2
1Institute of Psychiatry and Neurology, Department of Neurosurgery, Warsaw, Poland
2Central Clinical Hospital Ministry of Interior in Warsaw, Department of Neurosurgery, Poland
DOI : 10.5137/1019-5149.JTN.9030-13.2 AIM: Multi-profile monitoring of various blood serum factors during acute subarachnoid haemorrhage (SAH) is crucial for successful treatment. The aim of the study is to evaluate the serum concentration of different blood factors in the acute period of SAH.

MATERIAL and METHODS: 31 patients with confirmed aneurysmal SAH were enrolled in a prospective study. The concentrations of the following serum compounds were assessed on the day of admission and reassessed after 5 days: lipids profile, cardiac functionality enzymes and markers, electrolytes, osmolality, CRP (C-reactive protein), glucose, creatinine, urine.

RESULTS: The mean level of high-density lipoprotein (HDL) changed significantly from 43.9±23.9 mg/dL to 27.5±19,8 mg/dL, p=0,013 (mean dif. 16.5±14,1 mg/dL; 37,3%). Concentration of low-density lipoprotein (LDL) decreased by 28.6% (mean dif. 26.78±61.32; p=0.047). Values of triglicerydes and total cholesterol did not differ significantly between the initial evaluations and these repeated after 5 days. The overall serum ions (Na+, K+, Mg2+, Ca2+) concentrations and osmolality did not differ significantly between the initial measurements and after 5 days from SAH. The only mean value that appeared to be substantially increased at initial measurement was NT–proBNP and reached 1928.8±4952 pg/ ml, this value dropped down to 392.87±1147.9 mg/ml after 5 days (mean dif. 1535.96±4808.76 pg/ml; 79,6%; p = 0.247). CRP increased over 2 fold after 5 days up to 29.267±28.614 mg/L (mean dif. 16.06±34.05 pg/L; 121.6%; p=0.028). At 5-day follow up hematocrit dropped to 33.38 ± 3.81% from the initial value of 39.63 ± 2,56% (p=0.02).

CONCLUSION: This study showed a significant decrease in the serum level of LDL and HDL, while triglycerides were moderately heightened. Routine monitoring of lipid profile and statin administration at the early stage of SAH is recommended. Keywords : Subarachnoid haemorrhage, Aneurysm, Lipids, Electrolytes, Cardiac enzymes

Corresponding author : Tomasz Tykockı, ttomasz@mp.pl