Correlation of Early Subarachnoid Hemorrhage on Serum Endothelin and von Willebrand Factor with Clinical and Radiological Parameters

Abstract

Objective:This study aimed to determine the changes in endothelin and von Willebrand factor (vWF) serum levels during early period aneurysmal subarachnoid hemorrhage (SAH) compared to healthy individuals and to analyze them according to clinical and radiological findings.Method:This is a prospective study consisting of 36 cases that were referred to our hospital’s emergency department between January 2018 and January 2019 for aneurysmal SAH. The control group had the same demographic features as our patients. The diagnosis of aneurysmal SAH was confirmed by computed tomography (CT), CT angiography, and digital angiography within the first 6 hours after admission. The patients’ blood samples were collected within 6 hours after the occurrence of severe headache. Endothelin and vWF levels in the blood of the patient and control groups were measured by photometric methods. The results were correlated with the endothelin and vWF levels of healthy individuals and compared with the patients’ Glasgow Coma scale (GCS) and Fisher scale (FS) scores.Results:Of the 36 patients included in this study, 24 (66.7%) were female and 12 were male (33.3%). The average age was 52.13±14.40 (range: 19 to 80) years. At the time of admission, GCS, and FS scores were 11.3 and 3.1 on average, respectively. A total of 36 healthy individuals (24 females and 12 males) with an average age of 49.6±11.7 (range: 22 to 76) years were included in the control group. A significant negative correlation was found between the FS score and the GCS score of the patients (r=-0.501, p=0.002). There was a significant correlation between the GCS score of the patients and the endothelin and vWF values. It was observed that there was an increasing rate of endothelin and vWF values as the GCS score decreased (r=-0.465 p=0.004, r=-0.465 p=0.004). There was also a significant relationship between FS score and endothelin and vWF values. It was observed that as FS score increased, endothelin, and vWF values also increased (r=0.571, p<0.001, r=0.538, p=0.001).Conclusion:Evidence suggests that inflammation plays an important role in the acute phases of aneurysmal SAH-related neural damage. Our study showed that serum endothelin and vWF levels increased in the first day of bleeding in aneurysmal SAH patients and that they were associated with the GCS and FS scores.

Keywords

• endothelin
• fisher scale
• subarachnoid hemorrhage
• von willebrand factor