INCREASE IN JUGULAR LEVELS OF POLYMORPHONUCLEAR NEUTROPHIL ELASTASE IN PATIENTS WITH ACUTE CEREBRAL INFARCTION

To elucidate the involvement of activated polymorphonuclear neutrophil (PMN) proteolytic activity in the pathophysiology of cerebrovascular stroke, we measured internal jugular venous and femoral arteria I leve ls of PMN elastase in 6 patients with acute stroke from the day of ons et (day 0) to 7 days after onset (day 7). Two patients with cerebral i nfarction demonstrated markedly elevated levels of PMN elastase in the jugular blood (730 and 1320 mu g l(-1), respectively), but not in the arterial blood (203 and 205 mu g l(-1), respectively) on day 2. Both patients manifested signs of hemorrhagic infarction early on day 2. On day 4, the increased levels of jugular PMN elastase returned to the n ormal range (<250 mu g l(-1)) in both patients. In contrast, none of t he 4 patients with intracerebral hemorrhage demonstrated increased lev els of PMN elastase in either the jugular or the arterial blood from d ays 0 to 7 The present study demonstrated a temporary but significant increase in jugular PMN elastase in patients with cerebral infarction, especially shortly after hemorrhagic infarction.