ENDOGENOUS NEUROPEPTIDES IN PATIENTS WITH ACUTE TRAUMATIC HEAD-INJURY.1. CEREBROSPINAL-FLUID BETA-ENDORPHIN LEVELS ARE INCREASED WITHIN 24HOURS FOLLOWING THE TRAUMA

The changes in the cerebrospinal fluid (CSF) beta-endorphin (beta-end) levels within 24 h following the trauma were examined in 45 patients with head injuries. CSF samples obtained from 25 healthy subjects who had minor surgical operations under spinal anaesthesia were included a s the controls. Patients with head injuries were evaluated according t o their Glasgow Coma Scale (GCS) scores on admission to the neurosurge ry clinic and four subgroups were formed as follows: Group I: minor he ad trauma (GCS: 13-15) without skull fracture; Group II: mild head inj ury (GCS: 13-15) with skull fracture; Group III: moderate head injury (GCS: 8-12) and Group IV: severe head injury (GCS: < 8). All patients with head injury had significantly higher CSF beta-end levels than the controls (P < 0.001). The levels in patients with mild head injury (G roup II) were significantly higher than those with severe head trauma (Group IV) (P < 0.001). There was not any correlation between the CSF beta-end changes and the GCS scores of the patients. Endogenous opioid peptides are suggested to have a role in central nervous system (CNS) injuries. However, the CSF levels of beta-end in patients with varyin g degrees of head trauma have not yet been clearly documented in the l iterature. In the present study, significant changes in CSF beta-end l evels are detected in patients with a wide range of head trauma (from minor head trauma to severe injury); however, the increased CSF beta-e nd levels were not correlated to the early prognosis of the patients.