The Role of Estrogen (Estradiol and Estrone) on the Development of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage
TL;DRAbstract
Delayed cerebral ischemia (DCI) is a significant complication following aneurysmal subarachnoid hemorrhage (aSAH). Recent evidence has suggested that biochemical mediators alter cerebral perfusion resulting in neurological decline. Estrogens (estrone–E1 and estradiol–E2) are mediators with demonstrated neuroprotective properties that could be implicated in DCI. The impact of E1 or E2 on outcomes in humans following aSAH has been understudied. The purpose of this study was to examine the association between E1 and E2 levels and DCI following aSAH. Plasma and cerebral spinal fluid (CSF) samples collected after hemorrhage on 99 acute, adult aSAH patients admitted to the Neurovascular ICU enrolled in a NIH funded study-RO1NR004339. Three plasma and up to 5 CSF samples were selected for E1 and E2 analysis from each patient representing early(1–4), middle(4-6) and late(7-10) days after hemorrhage and were assayed using liquid chromatography-tandem mass spectrometry. DCI was operationalized a
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Delayed cerebral ischemia (DCI) is a significant complication following aneurysmal subarachnoid hemorrhage (aSAH). Recent evidence has suggested that biochemical mediators alter cerebral perfusion resulting in neurological decline. Estrogens (estrone–E1 and estradiol–E2) are mediators with demonstrated neuroprotective properties that could be implicated in DCI. The impact of E1 or E2 on outcomes in humans following aSAH has been understudied. The purpose of this study was to examine the association between E1 and E2 levels and DCI following aSAH. Plasma and cerebral spinal fluid (CSF) samples collected after hemorrhage on 99 acute, adult aSAH patients admitted to the Neurovascular ICU enrolled in a NIH funded study-RO1NR004339. Three plasma and up to 5 CSF samples were selected for E1 and E2 analysis from each patient representing early(1–4), middle(4-6) and late(7-10) days after hemorrhage and were assayed using liquid chromatography-tandem mass spectrometry. DCI was operationalized a
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