Subarachnoid hemorrhage (SAH) is a life-threatening stroke caused by the spontaneous rupture of an intracranial artery aneurysm. Immediately after aneurysm rupture, a cascade of complex pathophysiological phenomena begins, leading to a poor patient outcome and a growing overall social burden. Cerebral artery vasospasm and late cerebral ischemia (SV/VSI) are the most frequent and severe complications occurring in the first 3 days after SAH, for the prevention of which new methods are developed, improved and developed, but the effectiveness of most of them depends on how quickly and accurately SV can be assessed /risk of VSI complications.
Previous clinical studies conducted by the applicant together with other scientists in Vilnius and Kaunas clinics allowed to develop and initiate patent of the technology of localized SV/VSI prediction, which is based on the flow of CSF and the transport of blood degradation products in the subarachnoid space by numerical modeling (US and EU patents pending) and to collect a unique clinical database of 135 SAH patients.
In the course of the project, additional preliminary studies were conducted to determine the relationships between the surface area and volume ratio of the CSF irrigated space and SV/VSI. Correlations between blood osmolarity and SV were also determined. It is very likely that further analysis of the data could lead to the discovery of more new biomarkers that would allow the identification of a very important patient-specific blood degradation product concentration threshold above which DCI or CV occurs. Also, combining new biomarkers with a numerical model of the transport of CSF and blood degradation products is expected to predict the timing and severity of SV/VSI events.
These studies would allow to expand the knowledge about the possible application of biomarkers for SV/VSI prognostication, and would also help to expand the range of patients for whom SV/VSI prognosis could be performed and to identify those patients whose prognosis would be currently unreliable due to special specificities.
Project funding:
Research Council of Lithuania (RCL), Projects of Postdoctoral fellowships funded by the state budget of the Republic of Lithuania
Project results:
The research idea of the proposed project is to perform a retrospective analysis of a collected database of patients with SAH and a numerical study of fluid dynamics in order to develop a patient-specific prediction of SV/VSI, including potential biomarkers.
Finally, a data-driven approach will be developed that can become part of an SV/VSI early warning system that will allow clinicians to implement optimal, patient-specific interventions to reduce SV/VSI events and improve patient outcomes.
Period of project implementation: 2024-11-04 - 2026-11-03
Project coordinator: Kaunas University of Technology
