Aboulhosn Rabii, Mofatteh Mohammad, Chaurasia Bipin, Abramyan Arevik, Roychowdhury Sudipta, Gupta Gaurav
Department of Acute Medicine, Aberdeen Royal Infirmary, Aberdeen, UK.
School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Ann Med Surg (Lond). 2025 Jul 15;87(9):5735-5742. doi: 10.1097/MS9.0000000000003603. eCollection 2025 Sep.
There have been growing efforts to identify predictors of Cerebral Vasospasm to facilitate earlier diagnosis and establish patient predictive models. This review discusses the implications of serum electrolytes, glycemic indices, and inflammatory markers in predicting the occurrence of aSAH-induced CV.
The literature was reviewed across PubMed, Scopus, Web of Science, Google scholars, the National Center for Biotechnology Information, the Centers for Disease Control and Prevention, the World Health Organization, and the National Institutes of Health. Studies were included within the following criteria: (a) focused on CV in human and (b) were published in peer-reviewed journals.
Studies included in this review comprised retrospective analyses, prospective studies, and systematic reviews. The literature suggests that hyponatremia is associated with the presence of CV post-aSAH. It is frequently encountered in the early phase postictally, emanating from the syndrome of inappropriate antidiuretic hormone secretion and cerebral salt wasting syndrome. Hyperglycemia, leukocytosis, elevated C-reactive protein levels and elevated cerebrospinal interleukin-6 levels also appear to be associated with the occurrence of CV post-aSAH.
The studies included in this review suggest that the presence of hyponatremia, hyperglycemia, leukocytosis, and elevated CRP and CSF IL-6 levels are associated with the occurrence of CV post-aSAH. Further research is required to scrutinize temporal relations and causality of described markers in the setting of aSAH-induced CV. Establishing a panel of biomarkers will facilitate the development of patient predictive models. Such models may stratify patient groups, institute therapeutic and endovascular interventions and ultimately reduce vasospasm-associated morbidity and mortality to improve patient outcomes.
为了便于早期诊断并建立患者预测模型，人们越来越努力地去识别脑血管痉挛的预测因素。本综述讨论了血清电解质、血糖指数和炎症标志物在预测动脉瘤性蛛网膜下腔出血（aSAH）诱发的脑血管痉挛（CV）发生中的意义。
对PubMed、Scopus、科学网、谷歌学术、美国国立生物技术信息中心、疾病控制与预防中心、世界卫生组织和美国国立卫生研究院的文献进行了综述。纳入研究的标准如下：（a）聚焦于人类的CV，（b）发表在同行评审期刊上。
本综述纳入的研究包括回顾性分析、前瞻性研究和系统评价。文献表明，低钠血症与aSAH后CV的存在有关。它在发作后的早期阶段经常出现，源于抗利尿激素分泌不当综合征和脑性盐耗综合征。高血糖、白细胞增多、C反应蛋白水平升高和脑脊液白细胞介素-6水平升高似乎也与aSAH后CV的发生有关。
本综述纳入的研究表明，低钠血症、高血糖、白细胞增多以及CRP和脑脊液IL-6水平升高与aSAH后CV的发生有关。需要进一步研究来仔细审查aSAH诱发的CV情况下所述标志物的时间关系和因果关系。建立一组生物标志物将有助于患者预测模型的开发。这样的模型可以对患者群体进行分层，制定治疗和血管内干预措施，并最终降低与血管痉挛相关的发病率和死亡率，以改善患者的预后。
