Cerebrospinal fluid nitrite/nitrate correlated with oxyhemoglobin and outcome in patients with subarachnoid hemorrhage.
The findings of various studies reporting temporal changes in CSF total nitrite/nitrate (NOx) levels after subarachnoid hemorrhage (SAH) vary considerably. The study group comprised 10 patients with SAH and 10 control subjects. Total nitrite/nitrate concentration was measured by a vanadium-based assay with the colorimetric Griess reaction. CSF oxyhemoglobin level was assessed by spectrophotometry. After an initial peak (22.6+/-10.1 microM) within first 24 h after SAH, CSF NOx decreased gradually during the period of observation. There was a significant correlation between CSF concentrations of NOx and OxyHb in the entire observation period (R=0.87, p<0.001). When the impact of bleeding into CSF was considered, patients with very good outcome [Glasgow Outcome Scale (GOS)=5] had significantly lower CSF NOx (11.1+/-1.3 microM) than those with worse outcome (GOS<5) (21.8+/-11.2 microM, p<0.01). In conclusion, this study demonstrates that after aneurysm rupture CSF NOx levels correlate with OxyHb. We suggest this as a novel interpretation of other variable findings in relation to NO metabolites in the central nervous system (CNS) post SAH, and hence it could usefully be incorporated into the planning of future studies, correlating NOx with clinical outcome.
Rejdak
Konrad
K
Department Neuroinflammation, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
Petzold
Axel
A
Sharpe
Martyn A
MA
Kay
Andrew D
AD
Kerr
Mary
M
Keir
Geoff
G
Thompson
Edward J
EJ
Giovannoni
Gavin
G
D000328:Adult; D000368:Aged; D015415:Biomarkers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000134:cerebrospinal fluid*; D009573:Nitrites / Q000134:cerebrospinal fluid*; D010108:Oxyhemoglobins / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000134:cerebrospinal fluid* / Q000175:diagnosis*; D014639:Vanadium
D015415:Biomarkers; D009566:Nitrates; D009573:Nitrites; D010108:Oxyhemoglobins; D014639:Vanadium