CREATINE-KINASE BB AND NEURON-SPECIFIC ENOLASE IN CEREBROSPINAL-FLUIDIN THE DIAGNOSIS OF BRAIN INSULT

Cerebrospinal fluid (CSF) markers provide useful information about the extent of brain damage. These biochemical indices may also be used wh en postmortem histopathological examination does not confirm antemorte m brain insult. Seven biochemical parameters-creatine kinase (CK), cre atine kinase BB isoenzyme (CK-BB), lactate dehydrogenase (LDH), gamma- glutamyltransferase, aldolase, leucine aminopeptidase (LAP), and neuro n-specific enolase (NSE)-were analyzed in CSF from 82 cadavers. Case s tudies were categorized into one of four diagnostic groups. There were 15 cases of head trauma, 23 of hypoxia (hangings, carbon monoxide, an d drug poisonings), 23 sudden cardiac death, and 21 miscellaneous case s. The degree of craniocerebral trauma was graded. In CSF there was a statistically significant correlation between the severity of cranioce rebral trauma and levels of CK, CK-BB, aldolase, LDH, and LAP. CSF CK- BB [median U/L (range)] for the groupings of head trauma, hypoxia, sud den cardiac death, and miscellaneous were, respectively, 873 (1-12,100 ), 26 (2-2,780), 16 (1-42), and 18 (0-2,780). Corresponding CSF CK lev els were 9,370 (28-67,842), lot (18-36,840), 180 (10-29,622), and 264 (17-26,556). There were no statistical significant differences among t he NSE concentrations in the four diagnostic groups. The testing of bi ochemical markers could be a reliable indicator of the degree of brain insult in support of morphological studies.