Iron-related Brain Damage After Spntaneous Intracerebral Bemorrhage

Objective:A growing number of studies have shown that iron plays a detrimental role in nerve damage and edema formation after cerebral hemorrhage. Ferritin and transferrin are different forms of iron.This study investigates whether ferritin and transferrin’s levels are associated with the outcome of spontaneous cerebral hemorrhage.Methods:We prospective studied71patients with spontaneous intracerebral hemorrhage within24hours from onset of symptoms. NIHSS score, GCS score, and blood tests were measured at admission. Serum ferritin and transferrin were measured within24hours,3days,7days and14days. Hematoma volumes, peripheral edema volumes, relative edema and the coefficient of hematoma and edema variation were measured within24hours,3days and7days. NIHSS score were measured at discharge, Modified Rankin Scale were measured at90days to assess the recovery of neurological function. Modified Rankin Scale score>2was considered with poor outcome. At the same time to collect a group of serum ferritin and transferrin from healthy people as control. Results:39.62%(21/52) of the patients had MRS score>2. Serum ferritin increased at the3days[247.80ng/ml (21.60-1369.50)], peaked at the7days[345.45ng/ml (46.60-1050.00)], the14days were still stayed at a high level[344.20ng/ml (40.40-1068.00)]. Serum transferrin peaked at the3days [2.07g/l(0.83-7.10)],then descended slowly,the14days still stayed at a high level[(1.93g/l (1.03-7.21)].Serum ferritin’s level on the day3were correlated with edema volume, the correlation coefficient was0.456. The higher the serum ferritin quartile, the worser the outcome.But there were no correlation with serum transferrin and the outcome. Older age, higher temperature, higher blood sugar, lower red blood cells, higher MCV, higher the MCH, higher of CRP, higher serum ferritin, higher NIHSS score, lower GCS score, larger hematoma volumes, larger edema volumes were associated with poor outcome.Conclusion:The quartile of serum ferritin and transferrin were incrersed after spontaneous intracerebral hemorrhage.Higher serum ferritin levels were associated with poor outcome. These findings may suggest that serum ferritin could response the change of iron after spontaneous intracerebral hemorrhage more sensitive,which could response the iron neurotoxicity indirectly.