The Influence of Oxidative Stress on Neurological Outcomes in Spontaneous Intracerebral Hemorrhage
Julia Masomi-Bornwasser,
Elena Kurz,
Christina Frenz,
Jan Schmitt,
Dominik M. A. Wesp,
Jochem König,
Johannes Lotz,
Florian Ringel,
Thomas Kerz,
Harald Krenzlin,
Naureen Keric
Affiliations
Julia Masomi-Bornwasser
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Elena Kurz
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Christina Frenz
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Jan Schmitt
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Dominik M. A. Wesp
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Jochem König
Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Johannes Lotz
Institute of Clinical and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Florian Ringel
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Thomas Kerz
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Harald Krenzlin
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Naureen Keric
Department of Neurosurgery, University Medical Center of the Johannes Gutenberg University, 55131 Mainz, Germany
Spontaneous intracerebral hemorrhage (ICH) causes, besides the primary brain injury, a secondary brain injury (SBI), which is induced, amongst other things, by oxidative stress (OS) and inflammation, determining the patient’s outcome. This study aims to assess the impact of OS in plasma and cerebrospinal fluid (CSF) on clinical outcomes in patients with ICH. A total of 19 ICH (volume > 30 cc) patients and 29 control patients were included. From day one until seven, blood and CSF samples were obtained, and ICH volume was calculated. OS markers, like malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione-sulfhydryl (GSH), and the total antioxidant status (TAS) were measured. Clinical data on treatment and outcome were determined. Patients with mRS ≤ 4 showed significantly elevated SOD and GSH-Px levels in plasma compared to patients with poor CO (p = 0.004; p = 0.002). Initial increased TAS in plasma and increased MDA in CSF were linked to an unfavorable outcome after six months (p = 0.06, r = 0.45; p = 0.05, r = 0.44). A higher ICH volume was associated with a worse outcome at week six (p = 0.04, r = 0.47). OS plays a significant role in SBI. Larger ICHs, elevated MDA in CSF, and TAS in plasma were associated with a detrimental outcome, whereas higher plasma-SOD and -GSH-Px were associated with a favorable outcome.
