PLATELET-DERIVED GROWTH-FACTOR AND SUBARACHNOID HEMORRHAGE - A STUDY ON CISTERNAL CEREBROSPINAL-FLUID

Platelet derived growth factor (PDGF) was identified as a powerful mit ogenic growth factor which is released from activated platelets and ha s a marked activity as vasoconstrictor agent. In the present study we have measured cisternal cerebrospinal fluid (CSF) levels of PDGF in 72 patients operated on for intracranial aneurysm in order to verify whe ther it might be related to the clinical aspects of SAH with special r egard to symptomatic vasospasm. CSF samples were obtained at surgery b y cisternal puncture of the subarachnoid cistern the nearest to the an eurysm before aneurysm isolation and exclusion. The specimen were froz en in liquid nitrogen and stored at -80 degrees C until analysis. PDGF was measured using a commercially available reagent. Values are expre ssed as pg/ml of CSF. In 18 cases no radiological and clinical signs o f SAH were detected and the mean cisternal CSF level of PDGF was 885.0 +/- 104.5 pg/ml; 20 patients were operated on between day 1 and 3 fro m the last SAH episode: mean cisternal CSF level of PDGF was 1917.5 +/ - 459.4 pg/ml. In 34 patients treated with delayed surgery protocol, m ean cisternal CSF level of PDGF was 995.3 +/- 73.8 pg/ml. Statistical analysis showed significant differences between groups (P: 0.011). In the subgroup of patients operated on within day 3 after SAH, 6 present ed vasospasm and had mean cisternal CSF PDGF lever which was significa ntly higher (P < 0.01) than in 14 patients without vasospasm. In the d elayed ''surgical'' patients there was no significant difference in ci sternal CSF levels of PDGF considering the occurrence of vasospasm. Th e results of the present study suggest that (a) after SAH there is a s ignificant release of PDGF early after SAH and (b) higher levels of PD GF found in cisternal CSF of patients operated on within 72 hours afte r SAH may be predictive of symptomatic vasospasm.