on March 6, 2008
Published online before print March 6, 2008, doi: 10.1161/STROKEAHA.107.505735
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Submitted on September 27, 2007
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. * To whom correspondence should be addressed. E-mail: suzuki02{at}clin.medic.mie-u.ac.jp.
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.
Accepted on October 10, 2007
Cerebrospinal Fluid Tenascin-C Increases Preceding the Development of Chronic Shunt-Dependent Hydrocephalus After Subarachnoid Hemorrhage
Hidenori Suzuki MD, PhD*;
Key words: cerebrospinal fluid • extracellular matrix • hydrocephalus • subarachnoid hemorrhage • tenascin-C