Evaluation of the secretory pattern of plasma arginine vasopressin in stroke patients

Arginine vasopressin (AVP) may play a role in the development of ischemic b rain edema and/or cerebral vasospasm. Data available on AVP plasma levels i n ischemic stroke are few and discordant. In order to ascertain whether cha nges in AVP plasma levels occur in ischemic stroke, plasma AVP levels, plas ma osmolality and mean arterial pressure were determined in 24 patients wit h unprecedented ischemic cerebral infarction and in 15 controls over a 24-h our period. In stroke patients, mean 24-hour plasma AVP levels (7.2 +/- 0.8 ng/l) were higher (p < 0.05) than in control subjects (2.4 +/- 0.3 ng/l), and correlated with the severity score of the neurologic deficit and the me an size of the lesion. In patients with a more severe neurologic deficit, t he mean 24-hour plasma AVP levels (8.7 +/- 1.0 ng/l) were higher than in pa tients with a less severe neurologic deficit (5.2 +/- 0.8 ng/l). Data indic ate that in ischemic stroke an increased AVP secretion occurs independently of osmotic or baroreceptorial mechanisms. The possibility that AVP may pla y a role in neuronal cell damage following cerebral ischemia warrants furth er attention. Copyright (C) 2001 S. Karger AG, Basel.