COMPARISON OF BIOCHEMICAL MARKERS IN CEREBROSPINAL FLUID AND SERUM BETWEEN ENDOVASCULAR THERAPY AND SURGERY FOR PATIENTS WITH SUBARACHNOID HEMORRHAGEE; NEURON-SPECIFIC ENOLASE, S-100B PROTEIN, BASIC FIBROBLAST GROWTH FACTOR, AND VASCULAR ENDOTHELIAL GROWT

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PURPOSE: The outcome of patients with subarachnoid hemorrhage (SAH) and the incidenceof symptomatic vasospasm in encovascular therapy are well known to be significantly better than in surgical therapy. Some biochemical markers are known as possible indicators of brain damage. We tried to clarify the possible mechanism, which is related to the better prognosis of endovascular treatment than surgery by measuring biochemical markers. METHODS: We examined cerebrospinal fluid (CSF) levels of neuron specific snolase (NSE), S-10B protein, basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and serum level of NSE in 21 patients with aneurysmal SAH, and compared the results of biochemical markers between endovascular therapy and surgical therapy. RESULTS: The incidence of symptomatic vasospasm was sigbificantly higher (p<0.05) in surgical group than in endovascular group. Repeated measures of NSE from serum in endovascular group were significantly lower (p<0.01) than in surgical group. Repeated measures of NSE, S-100B, VEGF and bFGF from CSF were not significantly different between endovascular group and surgical group. CONCLUSION: The present data is not conclusive to explain the clinicaldifference between endovascular therapy and surgery from the aspect of biochemical marker levels. The higher incidence of vasospasm in surgical group may not be related to the operative dameges.
2010-02-01