Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov;5(Suppl 1):S22-7.
doi: 10.4103/0976-3147.145196.

Correlation between plasma total nitric oxide levels and cerebral vasospasm and clinical outcome in patients with aneurysmal subarachnoid hemorrhage in Indian population

Shruthi Shimoga Ramesh  1 , Aripirala Prasanthi  2 , Dhananjaya Ishwar Bhat  2 , Bhagavatula Indira Devi  2 , Rita Cristopher  1 , Mariamma Philip  3
Affiliations

Correlation between plasma total nitric oxide levels and cerebral vasospasm and clinical outcome in patients with aneurysmal subarachnoid hemorrhage in Indian population

Shruthi Shimoga Ramesh et al. J Neurosci Rural Pract. 2014 Nov.

Abstract

Context: Cerebral vasospasm remains a major cause of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH). Reduced bioavailability of nitric oxide has been associated with the development of cerebral vasospasm after aSAH. Such data is not available in Indian population.

Aims: The objective of the study was to measure the plasma total nitric oxide (nitrite and nitrate-NO x ) level in aSAH patients and healthy controls treated at a tertiary hospital in India and to investigate a possible association between plasma total nitric oxide level and cerebral vasospasm and clinical outcome following treatment in patients with aSAH.

Settings and design: A case-control study of aSAH patients was conducted. Plasma total NO x levels were estimated in aSAH patients with and without vasospasm and compared the results with NO x levels in healthy individuals.

Materials and methods: aSAH in patients was diagnosed on the basis of clinical and neuro-imaging findings. Plasma total NO x levels in different subject groups were determined by Griess assay.

Results: Plasma total NO x level was found to be significantly decreased in patients with aSAH when compared to controls. Plasma total NO x level in the poor-grade SAH group was lower than that in the good-grade SAH group. Plasma total NO x level further reduced in patients with angiographic (P < 0.05) and clinical vasospasm.

Conclusions: Reduced plasma NO x level is seen in aSAH patients as compared to normal individuals. In aSAH patients reduced levels are associated with increased incidence of cerebral vasospasm and poor outcome. Plasma total NO x level could be used as a candidate biomarker for predicting vasospasm and outcome for this pathology.

Keywords: Aneurysmal subarachnoid hemorrhage; cerebral vasospasm; nitric oxide; poor outcome.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Graphs showing the level of total nitric oxide (NOx) markers in plasma; (a) in control and SAH patients, (b) in patients with and without angiographic vasospasm, (c) in patients with and without clinical vasospasm. Values are given as mean ± SD (Mann-Whitney test) ***Significant at P < 0.001, *Significant at P < 0.05
Figure 2
Figure 2
Graph showing correlation between plasma total NOx concentration and GOS grading system, Values were given as the mean ± SD. Plasma total NOx levels in SAH patients with poor outcome (GOS.1, 2, and 3) was decreased significantly when compared to patients with good outcome (GOS.4 and 5) (Correlation coefficient = 0.148, P = 0.035)
See this image and copyright information in PMC

References

    1. Perazella MA, Tofteland ND, Salyers WJ., Jr Subarachnoid Haemorrhage. Hosp Physician. 2007;43:31–41.
    1. Kolias AG, Sen J, Belli A. Pathogenesis of cerebral vasospasm following aneurysmal subarachnoid haemorrhage: Putative mechanisms and novel approaches. J Neurosci Res. 2009;87:1–11. - PubMed
    1. Sercombe R, Dinh YR, Gomis P. Cerebrovascular inflammation following subarachnoid haemorrhage. Jpn J Pharmacol. 2002;88:227–49. - PubMed
    1. Koźniewska E, Michalik R, Rafałowska J, Gadamski R, Walski M, Frontczak-Baniewicz M, et al. Mechanisms of vascular dysfunction after subarachnoid haemorrhage. J Physiol Pharmacol. 2006;57(Suppl 11):145–60. - PubMed
    1. Pickard JD, Walker V, Brandt L, Zygmunt S, Smythe J. Effect of intraventricular haemorrhage and rebleeding following subarachnoid haemorrhage on CSF eicosanoids. Acta Neurochir (Wien) 1994;129:152–7. - PubMed

LinkOut - more resources