2026 American Academy of Neurology Abstract Website

Usama Abbas¹, Muzammil Hussain², Arwaa Chaudhry³, Afraah Mohammed Mouzzam⁴, Elsayed S. Moubarak⁵, Muhammad Hassaan Ansari⁶, Christian Cortes Armijo⁷
¹Department of Orthopedics surgery, Azra Naheed Medical College Superior University, ²INTERNAL MEDICINE, Nishtar Medical University, Multan, Pakistan, ³INTERNAL MEDICINE, Federal Medical College, Islamabad, Pakistan, ⁴INTERNAL MEDICINE, Ayaan Institute of Medical Sciences Telangana India, ⁵INTERNAL MEDICINE, Faculty of Medicine Cairo University, Cairo, Egypt, ⁶INTERNAL MEDICINE, DOw Medical College, Karachi, Pakistan, ⁷Universidad Autónoma de Nuevo León, Facultad de Medicina, México

Objective:

To determine the prognostic value of the inflammatory biomarkers i.e. Interleukin-6, tumor necrosis factor alpha, C-reactive protein(CRP) in assessing functional outcomes in patient with aneurysmal subarachnoid hemorrhage

Background:

Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency posing high mortality risks. However, timely interventions can significantly lower risks. Hence, prognostic biomarkers such as inflammatory cytokines like, interleukin-6(IL-6) tumor necrosis factor alpha(TNF-alpha) and C-reactive protein(CRP) can help predict functional outcomes after aSAH.

Design/Methods:

A thorough systematic-review and meta-analysis was carried-out following PRISMA guidelines. Databases like PubMed, Embase, Cochrane library and Web-of-Science were searched for Randomized Controlled Trials (RCTs) reporting IL-6, TNF-alpha, or CRP levels in the blood or cerebrospinal fluid of the patients who had confirmed aneurysmal Subarachnoid Hemorrhage. Pooled risk ratios (RRs) were calculated using random-effects models and Heterogeneity was assessed using the I² statistic.

Results:

Results from 1,742 patients analysed described a vivid pattern certifying that greater levels of inflammation during aSAH saw greater challenges in recovery. Upon investigation of individual biomarkers, 1.IL-6 showed the most pronounced difference between patient groups. 2.TNF-α was also significantly higher in patients with poor outcomes. 3.CRP levels were markedly elevated in those who did not recover as well.

Further, we found that measuring IL-6 directly from the CSF fluid was even better predictor of recovery than measuring it from blood. While the overall trend was clear, there was some natural variation between individual studies, which we attribute to differences in when samples were taken and how recovery was assessed. Finally, our analysis found no signs that these overall results were skewed by unpublished data, giving us more confidence in the findings.

Conclusions:

The high levels of inflammatory cytokines i.e. IL-6, TNF-alpha, CRP are linked with worsening functional outcomes after aSAH. Hence, these biomarkers can be used as the prognostic biomarkers for early risk stratification and management of aSAH.