LEVELS OF IMMUNOREACTIVE CYSTEINYL-LEUKOTRIENES IN CSF AFTER SUBARACHNOID HEMORRHAGE CORRELATE WITH BLOOD FLOW-VELOCITY IN TCD

Lipid peroxidation and enhanced arachidonic acid metabolism is activat ed after blood-brain cell contact. Previous studies have indicated tha t cysteinyl-leukotrienes (cys-LT) have the capacity to constrict arter ial vessels in vivo and in vitro suggesting their involvement in the p athogenesis of cerebral vasospasm. The purpose of this study was to me asure the amount of cyst-LT in the cerebro-spinal fluid (CSF) in corre lation with transcranial Doppler findings (TCD) in patients with aneur ysmal subarachnoid haemorrhage (SAH). In all patients early surgery wa s performed. In the first cisternal CSF-sample which was already colle cted intra-operatively an initial peak of cys-LT was detected, followe d by decreasing amounts of cys-LT during the next 5 days. The CSF-leve ls of immunoreactive cys-LT were significantly higher in those patient s who showed signs of vasospasm on transcranial Doppler sonography (TC D) (p < 0.001). Normalization of TCD values was accompanied by decreas ing levels of CSF-cys-LT. We found a significant correlation between t he amounts of immunoreactive cys-LT in cerebrospinal fluid and cerebra l vasospasm measured by TCD.