CONCENTRATION OF ENKEPHALINS IN CEREBROSPINAL-FLUID OF PATIENTS AFTERSEVERE HEAD-INJURY

We studied head-injured patients treated at the Department of Neurosur gery, Silesian University School of Medicine, Katowice. The patients u nderwent lumbar puncture on days 1, 4 and 7 for diagnostic reasons. Th e levels of leu-enkephalin (LENK) and met-enkephalin (MENK) were exami ned in 4.5 ml of cerebrospinal fluid (CSF). The control group included patients with lumbar discopathy from whom CSF fluid was collected dur ing myelography. Enkephalins were extracted by column chromatography a nd their levels were assayed radioimmunologically. The results indicat e that enkephalins may play a certain role in the pathophysiological r esponse of nervous tissue to traumatic injury. Constantly elevated MEN K levels together with decreasing LENK levels in patients with a Glasg ow coma scale score less than or equal to 8 may be useful as a poor pr ognostic factor. It is also suggested that LENK and MENK play differen t pathophysiological roles.