Sequential changes in plasma fibronectin in patients with subarachnoid hemorrhage.

Sequential changes in plasma fibronectin level in 17 patients with subarachnoid hemorrhage (SAH), with 16 due to ruptured cerebral aneurysms, were compared for patients with good and poor outcomes, and patients with and without vasospasm. Plasma fibronectin concentrations were measured by an immune diffusion method. The clinical outcome was evaluated 3 months after SAH according to the Glasgow Outcome Scale. Plasma fibronectin concentrations were significantly lower on days 3 (p < 0.02) and 9 (p < 0.05) after ictus in patients with poor outcomes (moderately disabled or worse) than in those with good outcomes (good recovery). Patients with vasospasm had lower fibronectin concentrations during the 4 weeks after ictus. Decreased levels of plasma fibronectin were correlated with poor outcomes, most related to vasospasm. Plasma fibronectin levels reflect the overall severity in patients with SAH and are a useful marker for prediction of the final clinical outcome.