Abstract:Objective To investigate dynamic relation of serum levels of vascular endothelial growth factor (VEGF) with occurrence and severity of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage (tSAH). Methods Fortyeight patients with tSAH were involved in the study. All the patients received CT imaging assessment. All patients received TCD dynamic monitoring of flow velocity of middle cerebral artery at days 1, 3, 5, 7, 10 and 15 after admission for clinical classification of CVS. The venous blood samples were obtained to determine VEGF levels in the serum by ELISA at days 1, 3, 5, 7, 10 and 15 after admission and dynamic relationship between CVS severity and serum VEGF was evaluated. Ten normal volunteers were included as the control group. Results Serum levels of VEGF in patients with secondary CVS were significantly higher than those without CVS and normal volunteers in the control group. Additionally, expression levels of VEGF in the serum kept persistent increase in patients with severe CVS.Conclusion Dynamic variation of serum VEGF levels in patients with tSAH may be an indicator of CVS severity and hence may provide a basis for early diagnosis of CVS.
. Correlation of cerebral vasospasm with vascular endothelial growth factor after traumatic subarchnoid hemorrhage[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(1): 21-24.
[1]Dupont SA, Wijdicks EF, Manno EM, et al. Prediction of angiographic vasospasm after aneurysmal subarachnoid hemorrhage: value of the Hijdra sum scoring system. Neurocrit Care, 2009,11(2):172-176.
[5]Oertel M, Boscardin WJ, Obrist WD, et al. Posttraumatic vasospasm: the epidemiology, severity, and time course of an underestimated phenomenon: a prospective study performed in 299 patients. J Neurosurg, 2005, 103(5):812-824.
[7]Servadei F, Murray GD, Teasdale GM, et al. Traumatic subarachnoid hemorrhage: demographic and clinical study of 750 patients from the European brain injury consortium survey of head injuries. Neurosurgery, 2002, 50(2):261-267;discussion 267-269.
[11]Dumont AS, Dumont RJ, Chow MM, et al. Cerebral vasospasm after subarachnoid hemorrhage:putative role of inflammation. Neurosurgery, 2003, 53(1):123-133; discussion 133-135.
[12]Mattioli C, Beretta L, Gerevini S, et al. Traumatic subarachnoid hemorrhage on the computerized tomography scan obtained at admission: a multicenter assessment of the accuracy of diagnosis and the potential impact on patient outcome. J Neurosurg, 2003, 98(1):37-42.
[13]Tavernier B, Decamps F, Vega E, et al. Systemic treatments of the vasospasm. Ann Fr Anesth Reanim, 2007, 26(11):980-984.
[14]Tejada JG, Taylor RA, Ugurel MS, et al. Safety and feasibility of intra-arterial nicardipine for the treatment of subarachnoid hemorrhage-associated vasospasm: initial clinical experience with high-dose infusions. Am J Neuroradiol, 2007, 28(5):844-848.
[15]Goodson K, Lapointe M, Monroe T, et al. Intraventricular nicardipine for refractory cerebral vasospasm after subarachnoid hemorrhage. Neurocrit Care, 2008, 8(2):247-252.
[16]Ogunshola OO, Stewart WB, Mihalcik V, et al. Neuronal VEGF expression correlates with angiogenesis in postnatal developing rat brain. Brain Res Dev Brain Res, 2000, 119(1):139-153.