To study the association of CSF inflammatory and vasoactive mediators with poor functional outcome in subarachnoid hemorrhage (SAH).

CSF samples were collected through an external ventricular drain (EVD) in a prospective SAH cohort (N= 67). We evaluated modified Rankin Scale (mRS) score at 3-month intervals and assessed the occurrence of vasospasm. Poor functional outcome was defined as mRS >2. Angiographic vasospasm was defined as >50% reduction in the caliber of any vessel on post-SAH day 7 cerebral angiogram. We compared the CSF profile of 28 cytokines (Human Magnetic Luminex Assay, R&D systems) in post-SAH day 1, 3 and 5 by outcome. Continuous variables were compared with Student’s t or Wilcoxon rank sum test depending on data distribution.

In the SAH cohort (mean age 55.1, 69% female), 67% had a Hunts and Hess ≥3 and 89% had a modified Fischer scale of ≥3. 48% had poor 3-month outcome and 36% had poor 6-month outcome. Out of the 28 cytokines, 3 were below measurement range and were excluded from analysis: CCL11/Eotaxin, IL10 and IL5. The top 3 markers showing strongest association with outcome were CSF VEGFR1 (p=0.0014), IL12p70 (p=0.0023) and CCL5/RANTES (p=0.0038).