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The World in Medicine
June 14, 2000

Stroke Damage From Iron

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JAMA. 2000;283(22):2923. doi:10.1001/jama.283.22.2923-JWM00004-3-1

High levels of iron stored in the body can intensify neurological damage immediately after a stroke.

In a study of 100 patients, researchers in Girona, Spain, measured levels of ferritin in the blood and CSF within 24 hours of stroke onset. Among 45 patients with progressing neurological decline, the median ferritin level was 391 ng/mL in plasma and 17 ng/mL in CSF. In patients whose conditions were stable or improving, median ferritin levels were 148 ng/mL in plasma and 5 ng/mL in CSF. "Patients with ferritin levels higher than 275 ng/mL are 80% more likely to have progressing stroke" than patients with lower levels, said Antoni Davalos, MD, of Hospital Universitari Doctor Josep Trueta. Davalos said iron may worsen stroke damage by increasing production of free radicals in brain cells and brain microvessel walls. He noted that high iron levels also may enhance the release of glutamate, a neurotransmitter linked with neurological damage following stroke.