Aneurysmal Subarachnoid Hemorrhage
Conditions
Keywords
endothelial progenitor cells, aneurysmal subarachnoid hemorrhage, vasospasm, BNP
Brief summary
Aneurysmal subarachnoid hemorrhage is a common and serious disease associated to a high rate of mortality and morbidity. Severe definitive neurological impairment can concern up to 30% of patients in relation with elevated intracranial pressure, hemorrhage recurrence and symptomatic cerebral arterial vasospasm. This latter complication is defined as a reversible reduction of cerebral artery's diameter occurring between the 4th and the 14th day after bleeding. Physiopathology is not well understood, but could involve endothelium, trough endothelial progenitor cells (EPC). Circulating EPC are bone marrow-derived cells with capacity of vasculogenesis and angiogenesis. EPC have been recognized playing a beneficial role in cardiovascular disease and ischemic stroke. EPC have never been studied in aneurysmal subarachnoid hemorrhage. The primary objective of this study is to compare the number of circulating endothelial progenitor cells between patients with a good neurological outcome (defined as a glasgow outcome scale = 1 or 2) and patients with a poor neurological outcome (glasgow outcome scale = 3, 4 or 5). Briefly, the number of circulating EPC will be measured at admission, and at day 3, 6, 10, 14, 21 in each consecutive patient suffering aneurysmal subarachnoid hemorrhage and hospitalized in Teaching Hospital of Besançon (France). The neurological outcome will be measured one year after subarachnoid hemorrhage.
Interventions
None listed
Sponsors
Centre Hospitalier Universitaire de Besancon
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* recent(\< 24 h) aneurysmal subarachnoid hemorrhage * written informed consent obtained from the patient or from close relatives
Exclusion criteria
* refusal to participate * Non-aneurysmal subarachnoid hemorrhage * aneurysmal subarachnoid hemorrhage with estimated date of bleeding \> 24 h * Chronic heart failure * Chronic medication able to modify the plasmatic level of BNP * Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| endothelial progenitor cells count | day 3 after bleeding |
Secondary
| Measure | Time frame |
|---|---|
| Endothelial progenitor cells count | day 0, 6, 10, 14, 21 after bleeding |
| Maximal amplitude of variation of EPC count | 3 weeks after bleeding |
| Plasmatic brain natriuretic peptide | day 0, 3, 6, 10, 14, 21 after bleeding |
Other
| Measure | Time frame | Description |
|---|---|---|
| Glasgow Outcome Scale | One year after bleeding | — |
| Vasospasm occurence | during the 3 weeks after bleeding | Vasospasm will be defined as at less one segmental narrowing of a cerebral artery diagnosed on cerebral angiography (angio scanner, angio-MRI or 4 axes cerebral arteriography). Cerebral angiography will be done as necessary according to the occurence of the following situations * a clinical neurological deterioration unexplained by another cause * a mean arterial blood flow speed higher than 2 m/s assessed in cerebral arteries by transcranial doppler or a significant elevation of the mean arterial blood flow speed on two consecutive evaluations |
Countries
France
Contacts
Primary ContactSébastien Pili-Floury, MD, PhD
Outcome results
None listed