Abstract

GFAP (glial fibrillary acidic protein) is a highly brain-specific astroglial protein. It helps maintaining and stabilizing the cytoskeleton. Acute intracerebral hemorrhage causes immediate mechanical destruction of astroglial cells with a rapid release of GFAP into the extracellular space and the bloodstream. On the other side, in ischemic stroke, necrosis, cytolysis and GFAP release does not occur before 6 to 12 hours after symptom onset. Thus, increased GFAP values may indicate intracerebral hemorrhage in the early hours after stroke symptom onset. The underlying pathophysiology of the test and the most relevant literature will be discussed in the presentation. Potential implications include a better prehospital triage of acute stroke patients, including the possibility to initiate hyperacute treatment such as blood pressure reduction in patients with intracerebral hemorrhage.