The Prognostic Value of Eryptosis Parameters in the Cerebrospinal Fluid for Cerebral Vasospasm and Delayed Cerebral Ischemia Formation

• Published in: World neurosurgery 2023-05, Vol.173, p.e578-e585
• Main Authors: Kaliuzhka, Vladyslav, Tkachenko, Anton, Myasoedov, Valeriy, Markevych, Mykyta, Onishchenko, Anatolii, Babalyan, Iurii, Piatykop, Volodymyr
• Format: Article
• Language: English
• Subjects: Brain Ischemia - diagnostic imaging; Brain Ischemia - etiology; Cerebral Infarction; Cerebral vasospasm; Eryptosis; Erythrocyte; Flow cytometry; Humans; Prognosis; Reactive oxygen species; Subarachnoid hemorrhage; Subarachnoid Hemorrhage - complications; Subarachnoid Hemorrhage - diagnostic imaging; Vasospasm, Intracranial - diagnostic imaging; Vasospasm, Intracranial - etiology
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2023.02.096

Delayed cerebral ischemia (DCI) and cerebral vasospasm (VS.) contribute to poor outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). The pathophysiology of DCI is not fully understood, and this has hindered the adoption of a uniform definition. Reliable diagnostic tests and effective evidence-based treatment are lacking. This study explored the possibility of using eryptosis parameters in the cerebrospinal fluid (CSF) as a marker for early detection of VS and DCI. Twenty-one SAH patients were recruited and treated at Kharkiv Regional Hospital. The occurrences of DCI and VS were also recorded. Flow cytometry was used to assess eryptosis indices in the CSF by analyzing phosphatidylserine externalization in erythrocytes using annexin V staining and evaluating reactive oxygen species generation using 2,7-dichlorodihydrofluorescein (DCF) diacetate staining. The percentage of annexin-positive red blood cells (RBCs) in the VS group was significantly higher than that in the non-VS group (P = 0.0017). Furthermore, higher values of this index were significantly associated with DCI formation (P