Measurement of GFAP in Nasal Exudate in the Differential Diagnosis between Ischemic Stroke and Intracerebral Hemorrhage.

Background: Differential diagnosis between ischemic stroke (IS) and intracerebral hemorrhage (ICH) is a great challenge. Recently, the discovery of cerebral lymphatic drainage toward the nostrils suggested nasal exudate (NE) as a new source for measuring biomarkers from neural damage.

Objectives: In this study, we sought to confirm whether glial fibrillary acidic protein (GFAP) levels in NE could identify ICH.

Methods: GFAP in nasal exudate (nGFAP) was studied in 5 IS and 5 ICH patients. All patients underwent neurological examination, brain computed tomography, laboratory tests, and measurement of nGFAP and serum GFAP.

Results: We found higher concentrations in ICH patients (p = 0.02). The area under the ROC curve for IS/ICH discrimination was 0.840, with a cut-off point of 0.06 pg/mg for 100% sensitivity and 80% specificity.

Conclusions: These findings suggest that nGFAP could be a useful biomarker for differential diagnosis between IS and ICH and opens a potential field of study for other biomarkers in NE in neurological disorders.