Development of the Cerebrospinal Fluid in Early Stage after Hemorrhage in the Central Nervous System
Petr Kelbich,
Aleš Hejčl,
Jan Krejsek,
Tomáš Radovnický,
Inka Matuchová,
Jan Lodin,
Jan Špička,
Martin Sameš,
Jan Procházka,
Eva Hanuljaková,
Petr Vachata
Affiliations
Petr Kelbich
Biomedical Centre, Masaryk Hospital Ústí nad Labem, 401 13 Ústí nad Labem, Czech Republic
Aleš Hejčl
Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, J. E. Purkinje University, 401 13 Ústí nad Labem, Czech Republic
Jan Krejsek
Department of Clinical Immunology and Allergology, Faculty of Medicine and University Hospital in Hradec Králové, Charles University in Prague, 500 03 Hradec Králové, Czech Republic
Tomáš Radovnický
Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, J. E. Purkinje University, 401 13 Ústí nad Labem, Czech Republic
Inka Matuchová
Biomedical Centre, Masaryk Hospital Ústí nad Labem, 401 13 Ústí nad Labem, Czech Republic
Jan Lodin
Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, J. E. Purkinje University, 401 13 Ústí nad Labem, Czech Republic
Jan Špička
Department of Clinical Biochemistry, Masaryk Hospital Ústí nad Labem, 401 13 Ústí nad Labem, Czech Republic
Martin Sameš
Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, J. E. Purkinje University, 401 13 Ústí nad Labem, Czech Republic
Jan Procházka
Department of Anesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital Ústí nad Labem, J. E. Purkinje University, 401 13 Ústí nad Labem, Czech Republic
Eva Hanuljaková
Biomedical Centre, Masaryk Hospital Ústí nad Labem, 401 13 Ústí nad Labem, Czech Republic
Petr Vachata
Department of Neurosurgery, Masaryk Hospital Ústí nad Labem, J. E. Purkinje University, 401 13 Ústí nad Labem, Czech Republic
Extravasation of blood in the central nervous system (CNS) represents a very strong damaged associated molecular patterns (DAMP) which is followed by rapid inflammation and can participate in worse outcome of patients. We analyzed cerebrospinal fluid (CSF) from 139 patients after the CNS hemorrhage. We compared 109 survivors (Glasgow Outcome Score (GOS) 5-3) and 30 patients with poor outcomes (GOS 2-1). Statistical evaluations were performed using the Wilcoxon signed-rank test and the Mann–Whitney U test. Almost the same numbers of erythrocytes in both subgroups appeared in days 0–3 (p = 0.927) and a significant increase in patients with GOS 2-1 in days 7–10 after the hemorrhage (p = 0.004) revealed persistence of extravascular blood in the CNS as an adverse factor. We assess 43.3% of patients with GOS 2-1 and only 27.5% of patients with GOS 5-3 with low values of the coefficient of energy balance (KEB p = 0.008) as the evidence of immediate simultaneously manifested intensive inflammation, swelling of the brain and elevation of intracranial pressure.
