LEAKAGE OF BRAIN-ORIGINATED PROTEINS IN PERIPHERAL-BLOOD - TEMPORAL PROFILE AND DIAGNOSTIC-VALUE IN EARLY ISCHEMIC STROKE

The clinical value of determination of CNS-specific proteins in periph eral blood at the acute phase of ischemic stroke is unclear. S-100 pro tein and neurone specific enolase were serially quantified in peripher al blood at the acute and subacute phase of ischemic stroke (hours 4, 8, 10, 24 and 72 after onset of symptoms). Whereas S-100 protein was d etected in none of the matched control subjects, this protein was obse rved in 17/24 of the stroke patients. Patients with detectable S-100 p rotein had significantly larger infarctions. Cortical infarctions had already significantly increased S-100 concentrations at days 1 and 3 c ompared to subcortical or brainstem infarctions. Patients with volumes of brain lesion of >5 ccm exhibited significantly increased serum lev els of S-100 at hours 10, 24 and 72 compared to those with lesion volu mes of <5 ccm. At hours 1(), 24 and 72, concentrations of S-100 correl ated with scores of neurological outcome. Although kinetics of release of neurone specific enolase showed a similar pattern of release in bl ood, no significant association to outcome or extent of brain damage w as observed. These results suggest that S-100 protein and not NSE may represent a useful serum marker of brain damage in acute stroke. (C) 1 997 Elsevier Science B.V.