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Unravelling the causes of cerebral damage in subarachnoid haemorrhage: might biomarkers help?
  1. A A Rabinstein
  1. Correspondence to:
 Dr Alejandro A Rabinstein
 Mayo Clinic College of Medicine, 200 First Street SW, Mayo W8, Rochester, MN 55905, USA; rabinstein.alejandro{at}

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The concentration of neurofilament high chain in CSF may represent a biomarker for ischaemic axonal damage

Aneurysmal subarachnoid haemorrhage (SAH) is very often associated with significant functional sequelae. The causes of cerebral injury in this condition are multiple, including the immediate effects of the initial bleeding (vasoparalysis, possible ischaemia, brain oedema, and sudden rise in intracranial pressure), early or delayed hydrocephalus, delayed ischaemia due to vasospasm, systemic complications (such as infections and hyponatraemia), and iatrogenic complications (for example, occlusion of penetrating arterial branches during clipping or coiling of the ruptured aneurysm).1 In this issue of the journal, Petzold et al (see page 753–9) present their provocative findings suggesting that secondary axonal degeneration may be responsible for poor recovery after SAH.2

The authors serially collected cerebrospinal fluid (CSF) samples from 17 …

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