Endothelin-1 levels in serum and cerebrospinal fluid after vasospasm following spontaneous subarachnoid haemorrhage

Purpose: The aim of the present study was to analyse endothelin-1 levels in serum and cerebrospinal fluid samples in patients with subarachnoid haemorrhage and evaluated the effects on vasospasm. Material and Methods: The patients were selected among those who referred to intensive care unit of neurosurgery department within several hours following subarachnoid haemorrhage. Subarachnoid haemorrhage was diagnosed through cerebral computed tomography and lumbar punction. First neurological examinations of the patients were evaluated according to Hunt-Hess classification and the blood quantity was detected by cerebral computed tomography according to Fisher classification. Results: Serum and cerebrospinal fluid samples of 20 patients enrolled into the present study were collected at days 1, 3, 5, and 7 after subarachnoid haemorrhage. Ten individuals without any vascular diseases, nervous system trauma or inflammatory disease were enrolled into the study as the control group. Samples were analyzed through micro-ELISA method and endothelin-1 levels in the serum and cerebrospinal fluid were detected. According to Hunt-Hess classification, 6 patients were evaluated as Stage I, 10 patients as Stage II, 2 patients as Stage III and 2 patients as Stage IV. Seventeen patients were detected as Stage II whereas 3 patients were Stage IV according to Fisher classification. Vasospasm was detected in cases 3, 6, 11 and 18 by digital subtraction angiography. Conclusion: It was determined that as the Fisher and Hunt-Hess classifications increased, the risk of cerebral vasospasm increased. The present study revealed that endothelin-1 levels increase after subarachnoid haemorrhage and Endothelin-1 particularly may play an important role in the vasospasm following spontaneous subarachnoid haemorrhage. Amaç: Bu çalışmanın amacı subaraknoid kanamalı hastalarda serum ve beyin omurilik sıvısı örneklerinde endotelin-1 düzeylerini analiz etmek ve vazospazm üzerindeki etkilerini değerlendirmektir. Gereç ve Yöntem: Hastalar subaraknoid kanamayı takiben birkaç saat içinde beyin cerrahisi bölümünün yoğun bakım ünitesine yatırılan hastalar arasından seçildi. Subaraknoid kanama teşhisi serebral bilgisayarlı tomografi ve lomber ponksiyon ile konuldu. Hastaların ilk nörolojik muayeneleri Hunt-Hess sınıflamasına göre değerlendirildi ve serebral bilgisayarlı tomografi ile tespit edilen kan miktarları Fisher sınıflamasına göre derecelendirildi. Bulgular: Çalışmaya dahil edilen 20 hastanın serum