• Rabih G Tawk, Sanjeet S Grewal, Michael G Heckman, Bhupendra Rawal, David A Miller, Drucilla Edmonston, Jennifer L Ferguson, Ramon Navarro, Lauren Ng, Benjamin L Brown, James F Meschia, and William D Freeman.
• *Department of Neurosurgery, Mayo School of Health Sciences, Mayo Clinic College of Medicine, Jacksonville, Florida; ‡Division of Biomedical Statistics and Informatics, Mayo School of Health Sciences, Mayo Clinic College of Medicine, Jacksonville, Florida; §Department of Neurology, Mayo School of Health Sciences, Mayo Clinic College of Medicine, Jacksonville, Florida; Departments of ¶Critical Care and ‖Neurology, Mayo Clinic, Jacksonville, Florida.
• Neurosurgery. 2016 Apr 1; 78 (4): 487-91.

BackgroundThe value of neuron-specific enolase (NSE) in predicting clinical outcomes has been investigated in a variety of neurological disorders.ObjectiveTo investigate the associations of serum NSE with severity of bleeding and functional outcomes in patients with subarachnoid hemorrhage (SAH).MethodsWe retrospectively reviewed the records of patients with SAH from June 2008 to June 2012. The severity of SAH bleeding at admission was measured radiographically with the Fisher scale and clinically with the Glasgow Coma Scale, Hunt and Hess grade, and World Federation of Neurologic Surgeons scale. Outcomes were assessed with the modified Rankin Scale at discharge.ResultsWe identified 309 patients with nontraumatic SAH, and 71 had NSE testing. Median age was 54 years (range, 23-87 years), and 44% were male. In multivariable analysis, increased NSE was associated with a poorer Hunt and Hess grade (P = .003), World Federation of Neurologic Surgeons scale score (P < .001), and Glasgow Coma Scale score (P = .003) and worse outcomes (modified Rankin Scale at discharge; P = .001). There was no significant association between NSE level and Fisher grade (P = .81) in multivariable analysis.ConclusionWe found a significant association between higher NSE levels and poorer clinical presentations and worse outcomes. Although it is still early for any relevant clinical conclusions, our results suggest that NSE holds promise as a tool for screening patients at increased risk of poor outcomes after SAH.

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