Stroke, Vol 22, 1254-1258, Copyright © 1991 by American Heart Association
A Aurell, LE Rosengren, B Karlsson, JE Olsson, V Zbornikova and KG Haglid
BACKGROUND AND PURPOSE: We initiated the present study to evaluate the
clinical value of consecutive concentration determinations of S-100 and
glial fibrillary acidic proteins in cerebrospinal fluid from patients with
brain infarction. METHODS: We took sequential samples of cerebrospinal
fluid from 28 patients within 48 hours, at 7 days, and at 18-21 days after
the ictus. We measured astroglial protein concentrations using an
enzyme-linked immunosorbent assay and also determined size of the
infarction (computed tomography), clinical state of the patient (simplified
activities of daily living test), blood- brain barrier dysfunction
(cerebrospinal fluid/serum albumin ratio), and a myelin marker (myelin
basic protein). RESULTS: We found a transient increase of both proteins in
the cerebrospinal fluid during the first week after the ischemic stroke (p
less than 0.05). This increment was significantly correlated with the size
of the infarction and the clinical state of the patients. CONCLUSIONS:
Transient release of astroglial proteins into the cerebrospinal fluid
possibly reflects initial focal ischemic damage and, in the later phase,
ongoing destruction of astroglial cells in the penumbra zone. We suggest
that determinations of cerebrospinal fluid astroglial protein
concentrations can be used to estimate ischemic brain damage, which should
be of particular value in clinical trials of pharmacological agents, such
as calcium antagonists, on stroke patients.
ARTICLES
Determination of S-100 and glial fibrillary acidic protein concentrations in cerebrospinal fluid after brain infarction
Institute of Neurobiology, University of Goteborg, Sweden.
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