SERUM NEURON-SPECIFIC ENOLASE AS AN INDICATOR OF STROKE VOLUME

Serum neurone-specific enolase (NSE) and computerized tomography (CT) stroke volume were compared in patients admitted within 24 h of an acu te stroke. Serum samples were obtained on admission and daily for the next 4 days. Of 163 patients, CT scans revealed 25 with intracerebral haemorrhages, one haemorrhagic infarct and 83 measurable acute infarct s. The serum NSE levels of those with infarcts was significantly highe r than in those with haemorrhages at 48 (P = 0 . 0003) and 72 h (P = 0 . 04). The maximum serum NSE value tended to occur later in those wit h large infarcts (P = 0 . 0035). There was a significant correlation b etween infarct volume and serum NSE at 48 h (r = 0 . 27, P = 0 . 015) and 96 h (r = 0 . 27, P = 0 . 015) and with the maximum serum NSE over the 4 days (r = 0 . 36, P = 0 . 001). There was no significant correl ation between haemorrhage volume and NSE. In conclusion, serum NSE may be a useful marker of infarct volume in studies of therapy in acute s troke, Sampling for NSE should continue, at least in those with large infarcts, for longer than 4 days. Serum NSE cannot be used to distingu ish between haemorrhage and infarction in patients with an acute strok e.