HeMoVal Research Group

The HeMoVal study: a prospective international multicenter cohort study investigating haemoglobin metabolites in cerebrospinal fluid and secondary brain injury after aneurysmal subarachnoid haemorrhage

HeMoVal is a multicentre research initiative originally designed to investigate longitudinal cerebrospinal fluid haemoglobin after aneurysmal subarachnoid haemorrhage, and to evaluate its association with secondary brain injury and clinical outcome.

Prospective design

Observational cohort with preregistered endpoints.

Longitudinal CSF sampling

Daily cerebrospinal fluid sampling across the early high-risk period.

Multicenter validation

Designed to assess robustness across independent centres.

Temporal course of cerebrospinal fluid sampling across the early phase after aneurysmal subarachnoid haemorrhage
Temporal course of cerebrospinal fluid sampling during the early high-risk period after aneurysmal subarachnoid haemorrhage.

Research focus

Following aneurysmal subarachnoid haemorrhage, haemoglobin released into the cerebrospinal fluid undergoes dynamic biochemical transformation over time. Substantial preclinical evidence supports cerebrospinal fluid haemoglobin as a key mediator in the development of secondary brain injury, through mechanisms including oxidative stress, nitric oxide scavenging, and downstream microvascular dysfunction. HeMoVal examines these haemoglobin-related processes using longitudinal biomarker measurements aligned with clinically defined secondary brain injury.

Mechanistic background linking subarachnoid haemorrhage, haemoglobin delocalization, nitric oxide depletion, and secondary brain injury
Mechanistic background of haemoglobin delocalization after aneurysmal subarachnoid haemorrhage, illustrating erythrolysis, haemoglobin diffusion, heme release, nitric oxide depletion, and downstream pathways contributing to secondary brain injury. Source: https://doi.org/10.1186/s12883-022-02789-w

Key resources

Contributors

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