Intraoperative values of S-100 protein, myelin basic protein, lactate, andalbumin in the CSF and serum of neurosurgical patients

Objectives-To assess the concentrations of S-100 protein, myelin basic prot ein (MBP), and lactate, and the (CSF)/serum albumin ratio (Qalb) during int racranial neurosurgical procedures. Methods-Samples of CSF from 91 patients with various CNS diseases were obta ined by aspiration of cisternal CSF at the beginning of surgery (before sta rting surgical manipulation of the brain) and concentrations of S-100 prote in, MBP, and lactate, and Qalb were determined. At the same time blood was sampled for determination of serum S-100 protein concentration. Patients we re divided into three groups according to the aetiology of their CNS diseas e (intracranial haemorrhage, n=11; benign intracranial mass lesion, n=52; m alignant neoplastic disease, n=28). Radiological and intraoperative charact eristics were documented. Results-in each of these three groups median values of all four CSF variabl es measured were raised. The occurrence of brain oedema and a midline shift correlated significantly with raised concentrations of MBP and Qa1b. Breac hing of the arachnoid layer, documented at surgery for benign lesions, corr elated with higher concentrations of MBP, lactate, CSF S-100 protein, and Q a1b. Conclusions-Intraoperative values of S-100 protein, MBP, lactate, and Qa1b are increased in patients with intracranial haemorrhage, benign intracrania l mass lesion, and malignant neoplastic disease. Breaching of the arachnoid layer and oedema is associated with higher concentrations of some of the a forementioned proteins. These biochemical data can serve as a basis for fur ther research into CSF specific proteins.