{
  "abstract": "Background Whether surgical haematoma evacuation leads to reduced brain damage in patients with spontaneous supratentorial intracerebral haemorrhage (SSICH) remains unknown. Blood biomarkers reflecting brain damage could aid in prognosticating the clinical outcome and hence support quantifying the benefit of surgical interventions.Methods Blood samples from 10 patients with SSICH in the phase II early minimally invasive image-guided endoscopic evacuation of intracerebral hemorrhage (EMINENT-ICH) pilot study ( NCT04805177, completed) were collected longitudinally (at baseline, 24 hours, 3 days, 1 week, 1 month and 6 months after surgical haematoma evacuation). Neurofilament light chain (NfL), glial fibrillar acidic protein (GFAP), calcium-binding protein S100B and the inflammatory markers interferon-gamma, interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10 and tumour necrosis factor alpha were quantified. The perioperative and long-term course of concentrations and association with clinical outcome measures were assessed. A favourable outcome was defined as a modified ranking scale ≤3.Results Favourable outcome was observed in 60% (6/10) of patients (median age 72.5 years (IQR 67.5–79.8), 70% male), and in 70% (7/10) of patients, the preset goal of a postsurgery haematoma volume below 15 mL was achieved. On average, patients with unfavourable outcomes at 6 months had twofold higher NfL and sixfold higher GFAP concentrations compared with those with favourable outcomes (p NfL=0.127, pGFAP=0.017); concentrations of both markers were higher in patients with unsatisfactory haematoma evacuation (3.7-fold for NfL, p=0.0072 and 12.4-fold for GFAP, p=0.0122). Concentrations of other markers, especially ILs, were not indicative of functional outcomes.Conclusions Based on our results, we provide preliminary evidence that lower serum NfL and GFAP levels are associated with favourable clinical outcomes and successful haematoma evacuation in SSICH.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Tim Jonas Hallenberger"
    },
    {
      "affiliations": [
        "Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Eline Willemse"
    },
    {
      "affiliations": [
        "Department of Biomedicine, University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Catherine Brégère"
    },
    {
      "affiliations": [
        "Department of Biomedicine, University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Nilabh Ghosh"
    },
    {
      "affiliations": [
        "Rehabilitation Centre Rheinfelden, Rheinfelden, Switzerland"
      ],
      "name": "Leo H Bonati"
    },
    {
      "affiliations": [
        "Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Aleksandra Maleska Maceski"
    },
    {
      "affiliations": [
        "Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Pascal Benkert"
    },
    {
      "affiliations": [
        "Department of Neurology, Inselspital, Bern, Switzerland"
      ],
      "name": "Urs Fischer"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Jehuda Soleman"
    },
    {
      "affiliations": [
        "Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "David Leppert"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University Hospital and University Basel, Basel, Switzerland",
        "Department of Biomedicine, University Hospital and University Basel, Basel, Switzerland"
      ],
      "name": "Raphael Guzman"
    },
    {
      "affiliations": [
        "Multiple Sclerosis Centre and Research Center for Clinical Neuroimmunology and Neuroscience (RC2NB), Neurology, Departments of Biomedicine and Clinical Research University Hospital and University Basel, Basel, Switzerland",
        "Department of Neurology, University Hospital Basel, Basel, Switzerland"
      ],
      "name": "Jens Kuhle"
    }
  ],
  "title": "Evolution of blood biomarkers reflective of brain tissue damage and inflammation in the perioperative course of intracerebral haemorrhage evacuation in a phase II proof-of-concept trial",
  "uid": "59b2583b-bb37-5fb4-9cfd-3dcda3c4cde0"
}