The association between symptomatic delayed cerebral infarction and serum adhesion molecules in aneurysmal subarachnoid hemorrhage

Background: Serum concentrations of adhesion molecules may be connected to the pathogenesis of delayed cerebral infarction (DCI) after aneurysmal subarachnoid hemorrhage (SAH). Objective: To test the hypothesis that levels of adhesion molecules are substantially increased after DCI and decreased thereafter and that these levels can predict treatment outcomes. Methods: Serial circulating markers of adhesion molecules were examined in 21 consecutive SAH patients and 2 risk control subjects. All underwent cerebral angiography and magnetic resonance imaging to confirm the DCI. The timing of magnetic resonance imaging was fixed in the acute phase and before hospital discharge. Results: Symptomatic DCI developed in 33% of the patients (7 of 21). Statistical analysis of levels of adhesion molecules between patients with and those without DCI revealed that soluble (s) L-selectin, sP-selectin, and sE-selectin concentrations significantly increased after symptomatic DCI (P = .003, .013, and .043, respectively). Only higher sL-selectin level on presentation (cutoff value > 636 ng/mL) was significantly associated with poor outcome after 6 months of follow-up. Conclusion: Increased sL-selectin, sP-selectin, and sE-selectin levels imply risks of symptomatic DCI after aneurysmal SAH. The high frequency of symptomatic DCI and higher sL-selectin level on presentation may be associated with worse outcomes.