EFFECT OF INTRAVENTRICULAR HEMORRHAGE AND REBLEEDING FOLLOWING SUBARACHNOID HEMORRHAGE ON CSF EICOSANOIDS

CSF eicosanoid levels are raised following subarachnoid haemorrhage bu t not sufficiently to be vasoactive per se within the cerebral circula tion. Rebleeding and intraventricular haemorrhage are two factors asso ciated with a worse outcome after aneurysmal SAH. We have examined the effects of these two factors on the CSF levels of TXB2 (TXA2 metaboli te), PG 6-keto F1alpha (prostacyclin metabolite), PGF2alpha and PGE2 i n 44 patients following subarachnoid haemorrhage. In 15 patients who h ad received no non-steroidal anti-inflammatory agent or dexamethasone, intraventricular haemorrhage increased the median levels of all four eicosanoids in ventricular CSF by 2.1-5.1-fold. In 4 patients who rebl ed, the CSF median levels of all four eicosanoids were raised up to 25 0-fold over the normal range. These concentrations are just sufficient to have cerebrovascular and neuromodulatory effects.