Inflammation and platelet aggregation may be related to delayed ischemic neurological deficits after subarachnoid hemorrhage

肾上腺髓质素（AM）从脉络膜丛分泌到脑脊液（CSF）中，调节食欲。动脉瘤性蛛网膜下腔出血（SAH）发生后7-10天脑脊液中AM浓度升高。在SAH发病后（第0天）的早期（第3天）和晚期（第8天）测量所有结果变量。饮食口服热量摄入、自我报告的食欲水平、血红蛋白、白蛋白、葡萄糖和胰岛素水平在晚时间点低于早时间点。脑脊液AM浓度在晚时间点高于早时间点。AM浓度与饮食口服热量摄入和晚期自报食欲水平呈显著负相关。6例（27%）发展为DIND。发生DIND的患者在晚时间点AM浓度明显高于未发生DIND的患者。SAH发病后8天脑脊液AM浓度与食欲减退和DIND相关。

Adrenomedullin (AM) is secreted into the cerebrospinal fluid (CSF) from the choroid plexus and regulates appetite. AM concentration in the CSF is elevated 7–10 days after the onset of aneurysmal subarachnoid hemorrhage (SAH). All outcome variables were measured at an early (Day 3) and late (Day 8) time point after SAH onset (Day 0). Dietary oral calorie intake, self-reported appetite level, hemoglobin, albumin, glucose, and insulin levels were lower at the late time point than at the early time point. CSF AM concentration was higher at the late time point than at the early time point. There was a significant negative correlation between AM concentration and dietary oral calorie intake and self-reported appetite level at the late time point. Six patients (27%) developed DIND. AM concentration at the late time point was significantly higher in patients who developed DIND than in patients who did not. CSF AM concentration 8 days after SAH onset is related to appetite loss and DIND.