Neuroinflammation and Bispectral Index After Subarachnoid Hemorrhage

Study Overview
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Brief Summary
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Subarachnoid hemorrhage (SAH) is associated with a high mortality and frequently leads to severe disability in survivors caused by cerebral vasospasm and infarction. This study aims to elucidate the role of neuroinflammation (endocannabinoids and cortisol levels in cerebrospinal fluid) in the pathophysiology of cerebral vasospasm and the value of the bilateral bispectral index (BIS) for the early diagnosis of cerebral vasospasm.

Detailed Description
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Subarachnoid hemorrhage (SAH) or bleeding in the brain is a form of stroke. SAH mostly results from ruptured aneurysms. This severe disease often results in death or severe physical or cognitive disabilities and reduced quality of life. One frequent complication after SAH is cerebral vasospasm, a spasm of the big arteries accompanied by infarction of healthy brain tissue. The pathophysiologic processes which drive vasospasm remain unclear. This study aims to examine the role of endocannabinoids and cortisol in cerebrospinal fluid during the development of cerebral vasospasm. Additionally, this study examines whether side difference in the processed electroencephalogram (bilateral bispectral index) may be useful for early detection of cerebral vasospasm.

Official Title
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Pilot Study on the Role of Neuroinflammation in the Pathophysiology of Subarachnoid Hemorrhage and the Value of the Bilateral Bispectral Index for Early Diagnosis of Cerebral Ischemia After Subarachnoid Hemorrhage.

Conditions
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Subarachnoid Hemorrhage

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admission to neurosurgical ICU Klinikum der Universität München SAH External CSF drainage Exclusion Criteria: - AGE < 18

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Concentrations of endocannabinoids and corticoids in cerebrospinal fluid and blood. | Samples of cerebrospinal fluid and blood will be collected every day at 8am on hospital day 1-14 and the concentrations of the following substances will be determined: Anandamide 2-arachidonoylglycerol 2-arachidonoylglycerol-ether N-arachidonoyldopamine N-arachidonylglycine O-arachidonylethanolamide Palmitoylethanolamide Cortisol Corticotropin-releasing hormone (in CSF only) Corticosteroid-binding globulin (in blood only) | Once per day from day 1 until day 14 after hospital admission | 
| Bilateral Bispectral Index | The Bispectral Index is calculated every second by the BIS Vista monitor. These data will be recorded continuously from 0:01 am until 23:59 pm. | Every second from 0:01 am until 23:59 pm on hospital day 1,2,3,4,5,6,7,8,9,10,11,12,13,14 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Transcranial Doppler | The mean velocities in middle cerebral and anterior cerebral arteries will be determined by transcranial Doppler | Every day at 8 am from day 1 until day 14 after hospital admission | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cerebral vasospasm, Subarachnoid hemorrhage, Neuroinflammation, Bilateral Bispectral Index