Neurofilament light predicts neurological outcome after subarachnoid haemorrhage

Abstract To improve outcome prediction following subarachnoid haemorrhage (SAH), we sought a biomarker integrating early brain injury and multiple secondary pathological processes in prospective study of 42 non-traumatic SAH patients 19 control individuals. Neurofilament light (NF-L) was elevated CSF serum SAH. NF-L on Days 1–3 post-SAH strongly predicted modified Rankin score at 6 months, independent World Federation Neurosurgical Societies (WFNS) score. from Day 4 onwards also had profound impact outcome. link to SAH-specific process, investigated NF-L’s relationship with extracellular haemoglobin. Most haemoglobin not complexed haptoglobin, yet able be bound by exogenous haptoglobin i.e. scavengeable. scavengeable predictive subsequent NF-L. Next, efflux the after Serum correlated positively. The serum/CSF ratio lower versus subjects, keeping glymphatic dysfunction CSF/serum albumin increased controls. negatively ratio, indicating that transfer two proteins across blood–brain interface is dissociated. In summary, strong marker for clinical outcome, adding value WFNS score, promising surrogate end point trials.