Brain Disorders & Therapy

Early blood-brain barrier dysfunction predicts neurological outcome following aneurysmal subarachnoid hemorrhage

6^th International Conference on Brain Disorders and Therapeutics

September 13-15, 2018 | Copenhagen, Denmark

Svetlana Lublinsky

Ben Gurion University, Israel

Scientific Tracks Abstracts: Brain Disord Ther

Abstract:

Disease progression and delayed neurological complications are common after aneurysmal subarachnoid hemorrhage (aSAH). We aimed at targeting the potential of quantitative blood-brain barrier (BBB) imaging to predict disease progression and neurological outcome. We retrospectively, blindly and semi-automatically, analyzed magnetic resonance images from 124 aSAH patients scanned at four time points (24-48 h, 6-8 days, 12-15 days and 6-12 months) after the initial hemorrhage. Volume of brain with apparent pathology and BBB-dysfunction, subarachnoid space and lateral ventricles were measured. Neurological status on admission was scored using the Rosen-Macdonald scores (RMS). Clinical outcome at >six months was assessed using the extended Glasgow outcome scale. Based on repeated volumetric measures of pathological brain tissue and CSF, patients were grouped into progressive and non-progressive disease course. No differences were found between the groups in aneurysm locations, neurological status on admission or initial brain pathology. Females were older and more likely to have a non-progressive course compared to males. Progressive course was associated with worse outcome at >six months. A significant brain volume with BBB-dysfunction was found already 24-48 hours after admission, and persisted at all-time points. Brain volume with BBB-dysfunction was significantly larger in patients with progressive compared with non-progressive course. BBB-dysfunction increased the likelihood of a normal brain tissue to turn into a pathological one. A multi-linear regression model revealed a significant power for BBB-dysfunction in combination with RMS at 24-48 hours to predict patient outcome. We suggest that early identification of BBB-dysfunction may serve as a key predictive biomarker for neurological outcome in aSAH.

Biography :

Svetlana Lublinsky is completing her PhD studies under supervision of Professor Alon Friedman and Professor Ilan Shelef (Ben Gurion University, Israel). She has a Bachelor's degree in Electromechanical Engineering, and a Master's degree in Biomedical Engineering (Technion, Israel). Her research focuses on development of image processing methods, identification of imaging biomarkers, building prognostic and diagnostic tools. She has published and co-authored at 16 papers in reputed journals.

E-mail: slublinsky@gmail.com