2026-04-17T02:19:12Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/2281072026-04-07T18:08:09Zcom_2072_1057col_2072_478858col_2072_478917

00925njm 22002777a 4500 dc Llull Estrany, Laura author Santana Moreno, Daniel author Pedrosa Eguílaz, Leire author Laredo Gregorio, Carlos author Torné Torné, Ramon author Planas Obradors, Anna Maria author Chamorro Sánchez, Ángel author Amaro Delgado, Sergio author Mosteiro, Alejandra author Zattera, Luigi author Hurtado Restrepo, Paola A. author Werner, Mariano author Martín, Abraham author Chamorro Sánchez, Ángel author 2026-03-16T10:23:29Z 2026-03-16T10:23:29Z 2025-09-01 2026-03-12T13:07:05Z BACKGROUND: Spontaneous aneurysmal subarachnoid hemorrhage induces early blood-brain barrier permeability dysfunction, although its clinical relevance and underlying mechanisms remain poorly understood. We aimed to evaluate the association between blood-brain barrier disruption, quantified with dynamic contrast-enhanced magnetic resonance imaging at the end of the early brain injury period, circulating neuroinflammatory mediators, and long-term clinical outcomes. METHODS: We analyzed a prospective cohort of subarachnoid hemorrhage patients who underwent dynamic contrast-enhanced magnetic resonance imaging at a median (interquartile range) of 4 (2-6) days after clinical onset. Permeability maps were used to obtain K-trans values as a measure of increased blood-brain barrier permeability in the whole brain, gray matter, and white matter. Circulating neuroinflammatory molecules, including IL (interleukin) 8 and PDGF (platelet-derived growth factor), were measured using Multiplex-ELISA in blood samples collected concurrently with magnetic resonance imaging acquisition. Poor clinical outcome was defined as a modified Rankin Scale score of >2 at 90 days. Associations between K-trans values, neuroinflammatory mediators, and clinical outcomes were assessed using univariate and multivariate regression models. RESULTS: From 153 patients initially screened, 96 were finally included (63% females; median age, 55 years; 43% premorbid hypertension; 32% World Federation of Neurosurgical Societies grade 4-5; 31% poor outcome). In adjusted linear regression analyses, higher K-trans values were significantly associated with increased IL-8 (P=0.001) and PDGF (P=0.018) levels. In univariate analysis, K-trans values in white matter were significantly higher in patients with poor clinical outcome (median [interquartile range], 2.5 [2.07-6.09] x10(-3)min(-1)) compared with good clinical outcome (median [interquartile range], 2.0 [1.60-2.42] x10(-3)min(-1); P Barrera hematoencefàlica Embòlia i trombosi cerebral Blood-brain barrier Cerebral embolism and thrombosis Blood-Brain Barrier Disruption Predicts Poor Outcome in Subarachnoid Hemorrhage: A Dynamic Contrast-Enhanced MRI Study