Häni, Levin; Fung, Christian; Jesse, Christopher Marvin; Schild, Christof; Piechowiak, Eike Immo; Dobrocky, Tomas; Raabe, Andreas; Beck, Jürgen (2023). Cerebrospinal fluid biomarkers of superficial siderosis in patients with spontaneous intracranial hypotension. European journal of neurology, 30(1), pp. 235-240. Wiley 10.1111/ene.15591
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Euro_J_of_Neurology_-_2022_-_H_ni_-_Cerebrospinal_fluid_biomarkers_of_superficial_siderosis_in_patients_with_spontaneous.pdf - Accepted Version Available under License Publisher holds Copyright. Download (3MB) | Preview |
BACKGROUND
Spontaneous intracranial hypotension (SIH) is an important etiology of infratentorial superficial siderosis (iSS) of the central nervous system (CNS).1-7 However, the prevalence of iSS among patients with SIH is unknown and the imaging findings of iSS might represent a late stage of disease. We aimed to identify cerebrospinal fluid (CSF) biomarkers of iSS in patients with SIH.
METHODS
We included consecutive patients evaluated for SIH at our institution between 05/2017 and 01/2019. Lumbar CSF samples were analyzed for the presence of ferritin and bilirubin. MRI was assessed for the presence of iSS.
RESULTS
We included 24 patients with SIH. CSF samples were positive for bilirubin in 2/19 (10.5%). CSF ferritin was elevated in 7/23 (30.4%). Signs of iSS on imaging were present in four patients (16.7%). All patients with imaging signs of iSS demonstrated elevated CSF ferritin. Ferritin level was significantly higher among patients demonstrating iSS compared to those without (median 45.0 versus 11.0 μg/l; p=0.003). Symptom duration was longer in patients with iSS than in patients without iSS (median 40 months versus 9 months, p=0.018).
CONCLUSION
CSF alterations indicative of iSS are prevalent among patients with SIH. We speculate that a preclinical phase without symptoms or imaging signs, but during which elevated biomarkers of the disease are apparent from CSF analysis, might exist. We suggest incorporating measurement of CSF ferritin in the work-up of patients with SIH to identify those at risk of developing iSS.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology 04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry |
UniBE Contributor: |
Häni, Levin, Jesse, Christopher Marvin, Schild, Christof, Piechowiak, Eike Immo, Dobrocky, Tomas, Raabe, Andreas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1468-1331 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
11 Oct 2022 12:26 |
Last Modified: |
11 Oct 2023 00:25 |
Publisher DOI: |
10.1111/ene.15591 |
PubMed ID: |
36209476 |
BORIS DOI: |
10.48350/173652 |
URI: |
https://boris.unibe.ch/id/eprint/173652 |
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