Cisternal and lumbar CSF concentration of arachidonate metabolites in vasospasm following subarachnoid hemorrhage from ruptured aneurysm: biochemical and clinical considerations.
Two representative cases of subarachnoid hemorrhage in which prostaglandin D2 (PGD2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), stable metabolite of prostacyclin (PGI2), were monitored with serial lumbar punctures and detected in cisternal CSF during operations for aneurysm, are reported. In the case with demonstrated arterial vasospasm, prostaglandin D2 has a concentration trend with characteristic peak related to vasospasm; the synthesis of prostacyclin appears inhibited after the hemorrhage. In the patient without radiologic evidence of vasospasm, arachidonate metabolite concentration trend appears in a steady-state. Cisternal prostaglandin D2 concentration in the patient with demonstrated vasospasm is two times the highest lumbar CSF concentration, while 6-keto-prostaglandin F1 alpha concentration is very low. This suggests the role of the clotting phenomenon and likely confirms the importance of arachidonate metabolites in the genesis of cerebral arterial spasm following subarachnoid hemorrhage.
D015121:6-Ketoprostaglandin F1 alpha / Q000134:cerebrospinal fluid; D016718:Arachidonic Acid; D001095:Arachidonic Acids / Q000378:metabolism*; D002533:Cerebral Angiography; D002946:Cisterna Magna; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D002546:Ischemic Attack, Transient / Q000134:cerebrospinal fluid* / Q000000981:diagnostic imaging / Q000209:etiology; D008161:Lumbosacral Region; D015230:Prostaglandin D2; D011457:Prostaglandins D / Q000134:cerebrospinal fluid; D012422:Rupture, Spontaneous; D013116:Spinal Cord; D013345:Subarachnoid Hemorrhage / Q000150:complications
D001095:Arachidonic Acids; D011457:Prostaglandins D; D016718:Arachidonic Acid; D015121:6-Ketoprostaglandin F1 alpha; D015230:Prostaglandin D2