Biochemical profile of human infant cerebrospinal fluid in intraventricular hemorrhage and post-hemorrhagic hydrocephalus of prematurity

• Published in: Fluids and barriers of the CNS 2021-12, Vol.18 (1), p.62-62, Article 62
• Main Authors: Otun, Ayodamola, Morales, Diego M, Garcia-Bonilla, Maria, Goldberg, Seth, Castaneyra-Ruiz, Leandro, Yan, Yan, Isaacs, Albert M, Strahle, Jennifer M, McAllister, 2nd, James P, Limbrick, Jr, David D
• Format: Article
• Language: English
• Subjects: Analysis; Birth weight; Blood cell count; Cerebral Intraventricular Hemorrhage - cerebrospinal fluid; Cerebral Intraventricular Hemorrhage - complications; Cerebrospinal fluid; Cerebrospinal fluid (CSF); Cerebrospinal Fluid - chemistry; Chlorides; Cogeneration power plants; CSF electrolytes; CSF osmolality; Cytokines; Electrolytes; Enzymes; Extracellular matrix; Female; Glucose; Hemorrhage; Humans; Hydrocephalus; Hydrocephalus - cerebrospinal fluid; Hydrocephalus - etiology; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - cerebrospinal fluid; Infants; Inflammation; Intraventricular hemorrhage; Intraventricular hemorrhage (IVH); Magnesium; Male; Medical laboratories; Menstruation; Metabolites; Monocytes; Neurosurgery; Newborn babies; Pathophysiology; Pediatrics; Post-hemorrhagic hydrocephalus (PHH); Potassium; Proteins; Retrospective Studies; Sodium; Statistical analysis; Ventricle; Ventricular zone
• ISSN: 2045-8118; 2045-8118
• DOI: 10.1186/s12987-021-00295-8

Intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHH) have a complex pathophysiology involving inflammatory response, ventricular zone and cell-cell junction disruption, and choroid-plexus (ChP) hypersecretion. Increased cerebrospinal fluid (CSF) cytokines, extracellular matrix proteins, and blood metabolites have been noted in IVH/PHH, but osmolality and electrolyte disturbances have not been evaluated in human infants with these conditions. We hypothesized that CSF total protein, osmolality, electrolytes, and immune cells increase in PHH. CSF samples were obtained from lumbar punctures of control infants and infants with IVH prior to the development of PHH and any neurosurgical intervention. Osmolality, total protein, and electrolytes were measured in 52 infants (18 controls, 10 low grade (LG) IVH, 13 high grade (HG) IVH, and 11 PHH). Serum electrolyte concentrations, and CSF and serum cell counts within 1-day of clinical sampling were obtained from clinical charts. Frontal occipital horn ratio (FOR) was measured for estimating the degree of ventriculomegaly. Dunn or Tukey's post-test ANOVA analysis were used for pair-wise comparisons. CSF osmolality, sodium, potassium, and chloride were elevated in PHH compared to control (p = 0.012 -