ArticleJournal of anesthesia, analgesia and critical care2025
Cerebrospinal fluid analysis and changes over time in patients with subarachnoid hemorrhage: a prospective observational study.
Article in Journal of anesthesia, analgesia and critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Intracranial pressure physiology, monitoring and individualized management in the acute brain injured patient.Intensive care medicine · 2026Review
- Cerebrospinal fluid glucose-to-lactate ratio (CGLR) as a diagnostic biomarker for postoperative intracranial infections in patients with acute brain injury: a prospective diagnostic accuracy study.Frontiers in medicine · 2026Article
- Subarachnoid hemorrhage mediates human neocortical network, membrane potential, and action potential bursting via glutamate receptors.Communications biology · 2025Article
- Increased triglyceride-glucose index is associated with adverse functional outcome for patients with aneurysmal subarachnoid hemorrhage after surgical clipping and endovascular coiling: insights from a large cohort study.Frontiers in neurology · 2025Article
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10 authors.
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Abstract
backgroundChanges in cerebrospinal fluid (CSF) in patients with aneurysmal subarachnoid hemorrhage (aSAH) have not been fully elucidated, yet they are critical and may potentially be associated with the risk of complications. The aim of this study is to characterize the biochemical properties of CSF and examine the temporal changes in aSAH patients with and without post-aSAH complications such as vasospasm and shunt-dependent hydrocephalus.
methodsThis prospective observational longitudinal cohort study involved collecting CSF and arterial blood samples from SAH patients requiring an external ventricular drain at four different timepoints following the initial event (1-3, 4-7, 8-13, and 14-20 days after aSAH). A control group that comprised patients with idiopathic normal pressure hydrocephalus undergoing CSF sampling was included.
resultsA total of 20 SAH patients and 20 controls were enrolled. We observed significantly higher levels of hemoglobin (Hb), proteins, lactate, and cell concentrations in the CSF of aSAH patients compared to the control group (p < 0.001), with no corresponding differences in serum levels. Furthermore, a progressive decline in CSF Hb, proteins, and cells levels was noted over the days following the hemorrhage (p = 0.029, p = 0.005, and p = 0.010, respectively). Patients that developed vasospasm exhibited a lower CSF glucose/lactate ratio (p < 0.001) and reduced CSF sodium levels (p = 0.045), while patients that developed shunt-dependent hydrocephalus exhibited higher plasmatic and CSF glucose levels (p = 0.013 and p = 0.003, respectively) and lower CSF Hb/proteins ratio (p < 0.001).
conclusionsPatients with aSAH exhibit changes in the biochemical profile of the CSF, which evolve over time following the acute event. Parameters such as CSF glucose/lactate ratio and CSF Hb/proteins ratio could potentially provide valuable insights not only into the pathophysiology of aSAH but also into patient risks of post-hemorrhagic complications, such as vasospasm and hydrocephalus.
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