Brain specific cholesterol (24S-hydroxycholesterol) as a serum biomarker for hemorrhagic transformation in acute ischemic stroke
acute ischemic stroke patient presented to eR or in hospital within 8 hours from symptoms onset will be enrolled. Serum sample will collected on presentation at eR or in hospital and then on a daily base until day 5 or discharge. The serum level of 24S-hydroxycholesterol will be measured in Dr. David Russell's laboratory at uT Southwestern Medical Center, where 24S-hydroxycholesterol was first discovered. all patients will be evaluated daily by stroke attending for niHSS. all CT reports performed during admission will be collected. The primary outcome will be the biomarker in the blood for subjects with HT.Hu will be recorded according to the european Cooperative acute Stroke Study (eCaSS) morphologic definitions based on unenhanced head CT findings. Secondary outcome is mRS at 3 months assessed during routine clinic follow up. Correlation study of serum level of 24S-hydroxycholesterol with primary and secondary outcomes will be performed. Serum level of vascular endothelial growth factor (VeGF), fibronectin, Pai-1 and Serum S100B at presentation will be measured as well. Their sensitivity and specificity for HT will be compared with 24S-hydroxycholesterol.
1) Age: Adult > 18 years of age
2) Gender: both genders
3) Clinical: Present to ER with a diagnosis of ischemic stroke within 8 hours from symptom onset.
4) Neuroimaging (CT or MRI) performed as part of admission.