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This study assessed if hyperglycemia during EBI is associated with markers of neuroaxonal injury and whether these biomarkers partially account for the association between hyperglycemia and poor clinical outcome. Ninety-two SAH patients admitted within 24\u00a0h of bleeding onset were prospectively included. Glucose levels were measured at arrival and every 6\u00a0h for 72\u00a0h. Serum neurofilament light chain (NFL) levels were measured at 72\u00a0h. Functional outcome was assessed with the modified Rankin Scale (mRS) at 90\u00a0days (poor outcome, mRS\u2009&gt;\u20092). The association between glucose metrics, NFL levels, and clinical outcome was assessed with univariate and multivariate analyses. Mediation analysis was performed to examine the potential chain in which NFL may mediate the relationship between glucose and functional outcome. Higher glucose and NFL levels during EBI were associated with poor clinical outcome in adjusted analysis. NFL levels were associated with older age, higher initial severity, and higher glucose levels during EBI period. In adjusted mediation analyses, the association between glucose and clinical outcome was significantly mediated by NFL levels. The mediator NFL explained 25% of the association between glucose during EBI period and poor functional outcome at 90\u00a0days. In SAH, the association between glucose levels during EBI and poor clinical outcome might be significantly mediated by NFL levels. The link between hyperglycemia and poor clinical outcome might be explained in part through secondary neuroaxonal injury.<\/jats:p>","DOI":"10.1007\/s12035-024-04347-6","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T02:01:37Z","timestamp":1720749697000},"page":"1467-1477","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neuroaxonal Injury May Mediate the Association Between Hyperglycemia and Prognosis in Spontaneous Subarachnoid Hemorrhage"],"prefix":"10.1007","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7605-322X","authenticated-orcid":false,"given":"Daniel","family":"Santana","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1464-2237","authenticated-orcid":false,"given":"Laura","family":"Llull","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-0635","authenticated-orcid":false,"given":"Alejandra","family":"Mosteiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1852-4975","authenticated-orcid":false,"given":"Leire","family":"Pedrosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4757-2893","authenticated-orcid":false,"given":"Gabriel","family":"Pujol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8967-8472","authenticated-orcid":false,"given":"Luigi","family":"Zattera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1746-3226","authenticated-orcid":false,"given":"Mariano","family":"Werner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5357-4935","authenticated-orcid":false,"given":"Abraham","family":"Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0969-6158","authenticated-orcid":false,"given":"Carles","family":"Justicia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0493-5340","authenticated-orcid":false,"given":"\u00c1ngel","family":"Chamorro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7932-2528","authenticated-orcid":false,"given":"Ram\u00f3n","family":"Torn\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6838-6390","authenticated-orcid":false,"given":"Sergio","family":"Amaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"4347_CR1","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1016\/S0140-6736(16)30668-7","volume":"389","author":"RL Macdonald","year":"2017","unstructured":"Macdonald RL, Schweizer TA (2017) Spontaneous subarachnoid haemorrhage. 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