title: Cerebrospinal fluid nitrite/nitrate correlated with oxyhemoglobin and outcome in patients with subarachnoid hemorrhage.
abstract: 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.
authors.affiliation: Department Neuroinflammation, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
authors.forename: Konrad
authors.initials: K
authors.lastname: Rejdak
authors.forename: Axel
authors.initials: A
authors.lastname: Petzold
authors.forename: Martyn A
authors.initials: MA
authors.lastname: Sharpe
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Kay
authors.forename: Mary
authors.initials: M
authors.lastname: Kerr
authors.forename: Geoff
authors.initials: G
authors.lastname: Keir
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Thompson
authors.forename: Gavin
authors.initials: G
authors.lastname: Giovannoni
mesh_terms: 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
chemical_list: D015415:Biomarkers; D009566:Nitrates; D009573:Nitrites; D010108:Oxyhemoglobins; D014639:Vanadium