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(Stroke. 2008;39:1610.)
© 2008 American Heart Association, Inc.

Research Letters

Cerebrospinal Fluid Tenascin-C Increases Preceding the Development of Chronic Shunt-Dependent Hydrocephalus After Subarachnoid Hemorrhage

Hidenori Suzuki, MD, PhD; Noriaki Kinoshita, PhD; Kyoko Imanaka-Yoshida, MD, PhD; Toshimichi Yoshida, MD, PhD Waro Taki, MD, PhD

From Department of Neurosurgery (H.S., W.T.), Mie University Graduate School of Medicine, Tsu, Japan; Immuno-Biological Laboratories (N.K.), Takasaki, Japan; Department of Pathology and Matrix Biology (K.I.-Y., T.Y.), Mie University Graduate School of Medicine, Tsu, Japan.

Correspondence to Hidenori Suzuki, MD, PhD, Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. E-mail suzuki02{at}clin.medic.mie-u.ac.jp

Abstract

Background and Purpose— The possible cause of chronic hydrocephalus after subarachnoid hemorrhage (SAH) has been reported to be meningeal fibrosis. We examined whether the induction of tenascin-C (TN-C), an extracellular matrix glycoprotein known to promote tissue fibrosis, was associated with chronic hydrocephalus after SAH.

Methods— We prospectively measured cerebrospinal fluid TN-C levels in 7 control patients with unruptured cerebral aneurysms and in 29 consecutive patients with aneurysmal SAH on days 1 to 12.

Results— Cerebrospinal fluid TN-C levels were less than the diagnostic threshold level in control patients but markedly increased after SAH. Higher TN-C levels were observed in patients with more severe SAH on admission CT, ventricular drainage for acute obstructive hydrocephalus, and a worse outcome. Independent of these factors, however, cerebrospinal fluid TN-C levels were significantly higher in patients with than without subsequent chronic shunt-dependent hydrocephalus on days 1 to 9.

Conclusions— These findings suggest the possible involvement of TN-C in the development of chronic hydrocephalus after SAH and encourage further studies.

Key Words: cerebrospinal fluid • extracellular matrix • hydrocephalus • subarachnoid hemorrhage • tenascin-C