CEREBRAL BLOOD-FLOW AND EFFECTS OF CEREBROSPINAL-FLUID ON CALCIUM-TRANSPORT IN PATIENTS WITH CEREBRAL INFARCTION

Background and Purpose In this study we investigated whether cerebrosp inal fluid in patients with brain infarction possesses an activity tha t contributes to the evolution of brain ischemia. As a test, the effec t of cerebrospinal fluid on Ca2+ influx into the intracellular space w as chosen because this process is a mechanism for vasospasm, platelet aggregation as thrombi, and neuron damage. Methods Effects of cerebros pinal fluid taken from 48 patients with cerebral hemispheric infarctio n on the concentration of cytosolic flee Ca2+ in platelets were studie d using the fluorescent probe quin-2. Hemispheric cerebral blood flow was measured using Xe-133 intravenous injection. Results Cerebrospinal fluid in 19 of 48 patients with cerebral hemispheric infarction incre ased the level of cytosolic free Ca2+ in platelets. The course of the disease in the patients who showed a positive effect of cerebrospinal fluid on Ca2+, when compared with that of patients who showed a negati ve effect, was characterized by a more severe clinical manifestation a nd mortality. The decrease in hemispheric cerebral blood flow was more marked in both ischemic and contralateral hemispheres in patients wit h positive effects of cerebrospinal fluid on the level of Ca2+. Conclu sions These data suggest that the ability of cerebrospinal fluid to ev oke Ca2+ influx into the intracellular space in patients with brain in farction is a factor that aggravates ischemic brain damage.