Aneuvrysmal Subarachnoid Hemorrhage, Delayed Cerebral Ischemia, Endotheliopathy, Platelets Kinetic
Conditions
Keywords
aSHA, DCI, Endotheliopathy, Platelets
Brief summary
Aneurysmal subarachnoid haemorrhage is a complex pathology, the pathophysiology of which is still imperfectly understood. Its morbidity and mortality remain significant. In addition to the damage sustained by the brain in the immediate aftermath of aneurysmal rupture, which is inaccessible to life-saving treatment, a significant proportion of lesions occur at a distance from the initial event. Delayed cerebral ischaemia is one of the most morbid complications. It combines an inflammatory pattern with vascular dysfunction and neuronal excitotoxicity, leading to avoidable secondary neuronal loss. Vascular dysfunction is mediated by a loss of homeostasis between endothelial cells and figurative blood cells, including platelets. However, the interrelationship between these elements and the precise chronology of the dysfunction remain imperfectly described to date. It therefore seems appropriate to propose temporal monitoring of platelet activation kinetics over time, combined with concomitant collection of markers of endothelial damage, in order to clarify the vascular chronobiology of this pathology.
Interventions
OTHERblood test
During the routine blood test of the patient, 5 more tubes of 2.7 milliliters (mL) will be collected to make Platelet Activation Analysis
Sponsors
Hospices Civils de Lyon
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male and Female Adults ≤18 years of age. * Hospitalised in the neurological intensive care unit of the Pierre Wertheimer Hospital of the Hospices Civils de Lyon following an aneurysmal meningeal haemorrhage of any modified Fischer score, previously diagnosed by cerebral CT scan. * Patients admitted to the neurological intensive care unit or the NICU of the Pierre Wertheimer Hospital of the Hospices Civils de Lyon for an intra-parenchymal haematoma. * Patient who has been informed and has formulated his/her non-opposition, or close relative of the patient who has been informed and has formulated his/her non-opposition. * Affiliated to a social security scheme.
Exclusion criteria
* Non-aneurysmal SAH * Ischaemic stroke * Patients with previously known platelet function disorders * Pregnant or breast-feeding women * Patients under legal protection (guardianship, curatorship, safeguard of justice) * Patients under compulsory psychiatric care * Patients taking part in a study which may interfere with the present study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The difference in the percentage of platelets expressing P-selectin, reflecting their irreversible activation. | Day of blood sample (inclusion visit) Day 3, day 5, day 7 and day 10 after inclusion visit | To describe the temporal kinetics of the percentage of activated platelets over time between patients with aHSA compared with the control group, consisting of patients with spontaneous intraparenchymal haematomas. Platelet cell activation is defined by the concomitant presence of the following markers: P-Selectin (CD-62); Gp Integrin Alpha IIb Beta 3 (CD-41); phosphatidylserine. A mixed effects linear regression model will be used for data analysis. |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORNicolas Chardon, MD;Msc
Intensive care department; Pierre Wertheimer Hospital
Outcome results
None listed