back to 2010, vol. 16, b. 3

Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312 773X (Online)
Issue: 2010, vol. 16, book 3
Subject Collection: Medicine
Page: 27 - 31
DOI: 10.5272/jimab.1632010_27-31
Online date: Nov 24, 2010

J of IMAB 2010; 16(3):27-31
Maya Danovska1, Margarita Alexandrova2, Dora Peychinska1, I. Gencheva3
1) Neurology Clinic, University Hospital Pleven, Bulgaria
2) Department of Physics and Biophysics, Medical University Pleven, Bulgaria
3) Medical Diagnostic Clinical laboratory, University Hospital Pleven, Bulgaria

OBJECTIVE: The role of inflammation in the complex pathophysiology of spontaneous intracerebral hemorrhage (sICH) was studied by assessing the relationship between serum C-reactive protein (CRP) levels and some clinical and neuroradiological parameters. We also aimed to identify the effects of modifiable vascular risk factors on serum CRP levels.
PATIENTS: Forty six patients with sICH admitted to the Department of Neurology and Neurosurgery of the Pleven University Hospital, Bulgaria were examined. Serum CRP levels were measured within the first 48 hours of disease onset and analyzed in relation to neurological deficit severity and clinical outcome after sICH. The impact of some vascular risk factors on the inflammatory marker levels was also studied.
RESULTS: We found enhanced CRP levels in patients with severe neurological deficit as assessed by the National Institutes of Health Stroke Scale (NIHSS) score. Significantly higher CRP levels were measured in patients with progressive clinical deterioration and worse outcome. Serum CRP levels were also higher in patients with a history of alcohol abuse.
CONCLUSIONS: Our results suggest that inflammation plays a crucial role in the development of brain injury after sICH. They show that CRP, a nonspecific inflammatory marker, can serve as an additional diagnostic and prognostic test indicator in the acute stage of sICH thus providing an excellent opportunity for therapeutic interventions while the patient is still in clinic. Patients with a history of systemic alcohol abuse demonstrate stronger inflammatory response indicative for worse prognosis.

Key words: Intracerebral hemorrhage, inflammation, CRP, alcohol abuse, arterial hypertension.

- Download FULL TEXT( PDF 238 KB)
Please cite this article as: Danovska M, Alexandrova M, Peychinska D, Gencheva I. ALCOHOL ABUSE ENHANCES SYSTEMIC INFLAMMATORY RESPONSE IN PATIENTS AFTER SPONTANEOUS INTRACEREBRAL HAEMORRHAGE. J of IMAB. 2010; 16(3):27-31. DOI: 10.5272/jimab.1632010_27-31

1. Broderick J, Connolly S, Feldmann E, Hanley D, Kase C, Krieger D, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline from the American Heart Association/American Stroke Association Stroke Council, High Blood Pressure Research Council, and the Quality of Care and Outcomes in Research Interdisciplinary Working Group. Stroke. 2007 Jun;38(6):2001-23. Epub 2007 May 3. [PubMed] [CrossRef]
2. Qureshi AI, Mendelow AD, Hanley DF. Intracerebral hemorrhage. Lancet. 2009 May 9;373(9675):1632-44. [PubMed] [CrossRef]
3. Ribo M, Grotta JC. Latest advances in intracerebral hemorrhage. Curr Neurol Neurosci, 2006 Jan;6(1):17-22. [PubMed]
4. Rincon F, Mayer SA. Clinical review; Critical care management of spontaneous intracerebral hemorrhage. Crit Care. 2008; 12(6):237. [PubMed] [CrossRef]
5. Carmichael ST, Vespa PM, Saver JL, Coppola G, Geschwind DH, Starkman S, et al. Genomic profiles of damage and protection in human intracerebral hemorrhage. J Cereb Blood Flow Metab. 2008 Nov;28(11):1860-1875. [PubMed] [CrossRef]
6. Xi G, Keep RF, Hoff JT. Mechanisms of brain injury after intracerebral hemorrhage. Lancet Neurol. 2006 Jan;5(1):53-63. [PubMed] [CrossRef]
7. Zhang L, Liu C, Zhu C, Liu R, Li C, Zhu C, et al. Brain edema after intracerebral hemorrhage in rats: the role of inflammation. Neurol India. 2006 Dec;54(4):402-407. [PubMed] [CrossRef]
8. Wang J, Dore S. Inflammation after intracerebral hemorrhage. J Cereb Blood Flow Metab. 2007 May;27(5):894-908. [PubMed] [CrossRef]
9. Alexandrova, M, Bochev, P. Oxidative stress in stroke. Oxidative stress and neurodegenerative disorders, 2007 Elsevier, 307-362.
10. Di Napoli, M., Arakelyan, A., Boyajiyan, A., Godoy, D., Papa, F. The acute phase inflammatory response in stroke: systemic inflammation and neuroinflammation. Progress in Inflammation Research, 2006, Nova Science Publishers Inc, 95-145.
11. Herzig R, Urbanek K, Vlachova I, Krupka B, Gabrys M, Mares J, et al. The role of chronic alcohol intake in spontaneous intracranial hemorrhage: a carbohydrate-deficient transferring study. Cerebrovasc Dis 2003; 15(1-2):22-28. [PubMed] [CrossRef]
12. Xu T, Ju Z, Tong W, Hu W, Liu Y, Zhao L, et al. Zhang Y, Relationship of C-Reactive Protein With Hypertension and Interactions Between Increased C-Reactive Protein and Other Risk Factors on Hypertension in Mongolian People, China. Circ J 2008; 72: 1324–1328
13. Schwartz RS, Bayes-Genis A, Lesser JR, Sangiorgi M, Henry TD, Conover CA. Detecting vulnerable plaque using peripheral blood: Inflammatory and cellular markers. J Interv Cardiol 2003 Jun;16(3): 231–242. [PubMed] [CrossRef]
14. Torzewski J, Torzewski M, Bowyer DE, Frohlich M, Koenig W, Waltenberger J, et al. C-reactive protein frequently colocalizes with the terminal complement complex in the intima of early atherosclerotic lesions of human coronary arteries. Arterioscler Thromb Vasc Biol 1998; 18: 1386– 1392.
15. Thrift A, Donnan G, McNeil J. Heavy drinking, but not moderate or intermediate drinking, increases the risk of intarcerebral hemorrhage. Epidemilogy 1999; 30:537-541.
16. Zodpey S, Tiwari R, Kulkarni H. Risk factors for hemorrhagic stroke: a case-control study. Public Health 2000; 114:177-182.
17. Yan J, Hui R, Wang D. Elevated C-reactive protein levels predict worsening prognosis in Chinese patients with first-onset stroke. Front Med China 2009, 3 (1):30-35.
18. Gorelick P. Alcohol and stroke. Stroke 1988; 19:48-52.
19. Juvela S, Hillbom M, Palomaki H. Risk factors for spontaneous intracerebral hemorrhage Stroke 1995;26:1558-1564.
20. Klatsky AL, Armstrong MA, Friedman GD. Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and non-drinkers. Am J Cardiol.1990 Nov 15;66(17):1237-1242. [PubMed] [CrossRef]
21. Saloheimo P, Juvela S, Hillbom M. Use of aspirine, epistaxis, and untreated hypertension as risk factors for primary intracerebral hemorrhage in middle-aged and elderly people. Stroke 2001; 32:399-404.
22. Leppala J, Paunio M, Virtamo J, Fogelholm R, Albanes D, Taylor P, et al. Alcohol consumption and stroke incidence in male smokers. Circulation 1999; 100: 1209-214.
23. Hillbom M. Oxidants, antioxidants, alcohol and stroke. 1999 Frontiers and Bioscience 4 67-71.
24. Kleinig, T, Vink, R. Suppression of inflammation in ischemic and hemorrhagic stroke: therapeutic options. Curr Opin Neurol, 2009, 22, 294-301. [PubMed]

back to Online Journal