Serum amylase and lipase elevation is associated with intracranial events

Serum amylase and lipase elevation has been observed in trauma patients and patients with traumatic intracranial bleeding. However, the causes of this elevation have not been clearly elucidated. A further question remains as to whether other intracranial events are associated with such enzyme elevat ion as well. We retrospectively reviewed 75 patients consecutively admitted to Cook County Hospital Neurosurgical Intensive Care Unit over a 3-month p eriod for trauma, infection, tumor, or other space-occupying lesions with a n unstable condition or neurological deficit. Eleven patients (15%) had ele vated amylase and lipase levels. The patients were divided into two groups: Group I (n = 64) had normal and Group II (n = 11) had raised amylase and l ipase levels [amylase 402 +/- 444 U/L with normal less than or equal to 125 U/L and lipase 474 +/- 313 U/L with normal less than or equal to 55 U/L]. All Group II patients suffered an intracranial event. Twenty-four Group I ( 38%) and 10 Group II (91%) patients required craniotomy (P < 0.01). No pati ents had clinical or radiographic evidence of pancreatitis. In summary, int racranial events are associated with serum amylase and lipase elevation pro bably through centrally activated pathways. Because of the lack of diagnost ic value, routine pancreatic enzyme monitoring should not be performed in t his patient population.