Nitric oxide metabolites in cisternal CSF correlate with cerebral vasospasm in patients with a subarachnoid haemorrhage

A. Woszczyk, W. Deinsberger, D. K. Böker, Andreas Raabe, Volker Seifert, T. Dóczi

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background. The pathogenesis of cerebral vasospasm is likely to be multifactorial. Exposure of the adventitia of large cerebral arteries to blood breakdown products initiates a cascade of changes in both morphology and vasomotor regulation of the exposed vessels. The role of nitric oxide (NO) in development of cerebral vasospasm process is controversial. Basal cerebral vascular tone requires the continuous release of NO, nevertheless NO is involved in free radical mediated injury of endothelial cell membrane. Concentrations of nitrate/nitrite (stabile endproducts of NO metabolism) were studied in cisternal cerebrospinal fluid (cCSF) in patients suffering from aneurysmal subarachnoid haemorrhage (SAH). Method. 21 patients suffering from aneurysmal SAH were investigated. Treatment included aneurysm clipping, cisternal drainage of CSF and intravenous nimodipine in all patients as well as tripple H therapy when indicated. TCDS was performed on a daily basis. A mean flow velocity of more than 150 cm/sec and the development a delayed neurological deficit was defined as vasospasm. CSF samples were collected on the day of surgery and for the 7 days following. NO-M (nitrite and nitrate) were measured using a commercially available test kit. Findings. 5 of 21 patients developed clinically symptomatic vasospasm. There was a significant difference in NO levels between the groups. Patients with cerebral vasospasm showed significantly higher levels of NO-M in CSF than patients with a uncomplicated follow-up between day 2 and 8. Interpretation. Our preliminary results indicate that SAH leads to an increase in NO-M in CSF. This increase of NO-M significantly correlates with the flow velocities in TCDS measurement suggesting that NO plays an important role in the pathogenesis of cerebral vasospasm.

Original languageEnglish
Pages (from-to)257-264
Number of pages8
JournalActa Neurochirurgica
Volume145
Issue number4
DOIs
Publication statusPublished - Apr 1 2003

Fingerprint

Intracranial Vasospasm
Subarachnoid Hemorrhage
Nitric Oxide
Nitrites
Nitrates
Adventitia
Nimodipine
Cerebral Arteries
Ambulatory Surgical Procedures
Free Radicals
Aneurysm
Blood Vessels
Cerebrospinal Fluid
Drainage
Endothelial Cells
Cell Membrane

Keywords

  • Cerebral vasospasm
  • Cerebrospinal fluid
  • Free radicals
  • Nitric oxide
  • Nitric oxide synthetase
  • Subarachnoid heamorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Nitric oxide metabolites in cisternal CSF correlate with cerebral vasospasm in patients with a subarachnoid haemorrhage. / Woszczyk, A.; Deinsberger, W.; Böker, D. K.; Raabe, Andreas; Seifert, Volker; Dóczi, T.

In: Acta Neurochirurgica, Vol. 145, No. 4, 01.04.2003, p. 257-264.

Research output: Contribution to journalArticle

Woszczyk, A. ; Deinsberger, W. ; Böker, D. K. ; Raabe, Andreas ; Seifert, Volker ; Dóczi, T. / Nitric oxide metabolites in cisternal CSF correlate with cerebral vasospasm in patients with a subarachnoid haemorrhage. In: Acta Neurochirurgica. 2003 ; Vol. 145, No. 4. pp. 257-264.
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AU - Deinsberger, W.

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AU - Raabe, Andreas

AU - Seifert, Volker

AU - Dóczi, T.

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