Sequential Measurements of TxB<SUB>2</SUB> and 6-keto PGF<SUB>1α</SUB> in Cerebrospinal Fluid and Serum in Patients with Subarachnoid Hemorrhage

Abstract

Vasospasm following subarachnoid hemorrhage is a serious problem. In spite of extensive clinical and experimental research, the pathogenesis of cerebral vasospasm is still obscure. Recent advances in prostaglandin (PG) research has contributed to the study of stroke and cerebral vasospasm. It is indicated that PG is concerned in the pathogenesis of cerebral vasospasm. Thromboxane B2 (TxB2) and 6-keto prostaglandin F1α (6-keto PGF1α) in cerebrospinal fluid (CSF) and serum in patients suffering from subarachnoid hemorrhage with or without subsequent cerebral vasospasm were measured by radioimmunoassay. The mean value of CSF TxB2 in cases with vasospasm was 610 pg/ml, and in cases without vasospasm was 78 pg/ml. The mean value of CSF 6-keto PGF1α in cases with vasospasm was 1, 152 pg/ml, and in cases without vasospasm was 65 pg/ml. As for serum, the mean value of TxB2 in cases with vasospasm was 1, 672 pg/ml, and in cases without vasospasm was 346 pg/ml. The mean value of 6-keto PGF1α in cases with vasospasm was 312 pg/ml, and in cases without vasospasm was 117 pg/ml. Sequential measurements were performed in 5 cases with vasospasm and 5 cases without vasospasm. Values of TxB2 and 6-keto PGF1α in the CSF were elevated at the early stage of subarachnoid hemorrhage in cases with subsequent vasospasm, and the levels of TxB2 and 6-keto PGF1α in the CSF decreased gradually. The value of TxB2 in serum was elevated for 5 or 6 days after subarachnoid hemorrhage. In cases without vasospasm, TxB2 and 6-keto PGF1α in the CSF were constantly at low levels. In one case with vasospasm, TxB2 and 6-keto PGF1α levels in cisternal and ventricular CSF were compared. Cisternal CSF had higher TxB2 and 6-keto PGF1α values than ventricular CSF. Comparison of TxB2/6-keto PGF1α ratio in cases with or without vasospasm revealed no definite tendency. This study indicates that PG is closely related to cerebral vasospasm. Measurement of TxB2 and 6-keto PGF1α in CSF at the early stages of subarachnoid hemorrhage might be useful for the anticipation of vasospasm.