Skip to main content
Log in

Effect of intraventricular haemorrhage and rebleeding following subarachnoid haemorrhage on CSF eicosanoids

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

CSF eicosanoid levels are raised following subarachnoid haemorrhage but not sufficiently to be vasoactive per se within the cerebral circulation. Rebleeding and intraventricular haemorrhage are two factors associated with a worse outcome after aneurysmal SAH. We have examined the effects of these two factors on the CSF levels of TXB2 (TXA2 metabolite), PG 6-keto F (prostacyclin metabolite), PGF and PGE2 in 44 patients following subarachnoid haemorrhage. In 15 patients who had received no non-steroidal antiinflammatory agent or dexamethasone, intraventricular haemorrhage increased the median levels of all four eicosanoids in ventricular CSF by 2.1–5.1-fold. In 4 patients who rebled, the CSF median levels of all four eicosanoids were raised up to 250-fold over the normal range. These concentrations are just sufficient to have cerebrovascular and neuromodulatory effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Black P (1986) Hydrocephalus and vasospasm after subarachnoid haemorrhage from ruptured intracranial aneurysms. Neurosurgery 18: 12–16

    PubMed  Google Scholar 

  2. Boullin DJ, Bunting S, Blaso WP, Hunt TM, Moncada S (1979) Responses of human and baboon arteries to prostaglandin endoperoxides and biologically generated and synthetic prostacyclin: their relevance to cerebral arterial spasm in man. Br J Clin Pharmacol 7: 139–147

    PubMed  Google Scholar 

  3. Chan RC, Durity FA, Thompson GB, Nugent RA, Kendall M (1984) The role of the prostacyclin-thromboxane system in cerebral vasospasm following induced subarachnoid haemorrhage in the rabbit. J Neurosurg 61: 1120–1128

    PubMed  Google Scholar 

  4. Chehrazi BB, Giri S, Joy RM (1989) Prostaglandins and vasoactive amines in cerebral vasospasm after aneurysmal subarachnoid haemorrhage. Stroke 20: 217–224

    PubMed  Google Scholar 

  5. Clark FL, White RP (1989) Endothelium and cerebral vasospasm. Letter. J Neurosurg 70: 657–658

    Google Scholar 

  6. Chyatte D, Fode NC, Nichols DA, Sundt TM (1987) Preliminary report: effects of high dose methylprednisolone on delayed cerebral ischaemia in patients at high risk for vasospasm after aneurysmal subarachnoid haemorrhage. Neurosurgery 21: 157–160

    PubMed  Google Scholar 

  7. Cranston WI, Duff GW, Hellon RF, Mitchell D, Townsend Y (1976) Evidence that brain prostaglandin is not essential in fever. J Physiol 259: 239–249

    PubMed  Google Scholar 

  8. Fukumori T, Tani E, Maeda Y, Sukenaga A (1983) Effects of prostacyclin and indomethacin on experimental cerebral vasospasm. J Neurosurg 59: 829–834

    PubMed  Google Scholar 

  9. Gaetani P, Rodriguez y Baena R, Marzatico F (1993) Role of prostaglandins in delayed cerebral ischaemia after subarachnoid haemorrhage. Letter. Neurosurgery 32: 329

    PubMed  Google Scholar 

  10. Hedqvist P, Wennmalm A (1971) Comparison of the effects of prostaglandin E1, E2, and F on the sympathetically stimulated rabbit heart. Acta Physiol Scand 83: 156–162

    PubMed  Google Scholar 

  11. Maeda Y, Tani E, Miyamoto T (1981) Prostaglandin metabolism in experimental cerebral vasospasm. J Neurosurg 55: 779–785

    PubMed  Google Scholar 

  12. Mendelow AD, Stockdill G, Steers AJ, Hayes J, Gillingham FJ (1982) Double-blind trial of aspirin in patients receiving tranexamic acid for SAH. Acta Neurochir (Wien) 62: 195–202

    Google Scholar 

  13. Mohr G, Ferguson G, Khar Met al (1983) Intraventricular haemorrhage from ruptured aneurysm. Retrospective analysis of 91 cases. J Neurosurg 58: 482–487

    PubMed  Google Scholar 

  14. Nosko M, Schulz R, Weir B, Cook DA, Grace M (1988) Effects of vasospasm on levels of prostacyclin and thromboxane A2 in cerebral arteries of the monkey. Neurosurgery 22: 45–50

    PubMed  Google Scholar 

  15. Okamoto S, Handa H, Toda N (1984) Role of intrinsic arachidonate metabolites in the vascular action of erythrocyte breakdown products. Stroke 15: 60–64

    PubMed  Google Scholar 

  16. O'Neill P, Watton S, Foy PM, Shaw MDM (1991) Role of prostaglandins in delayed cerebral ischaemia after subarachnoid haemorrhage. Neurosurgery 30: 17–22

    Google Scholar 

  17. Pickard JD, Mackenzie ET (1973) Inhibition of prostaglandin synthesis and the response of baboon cerebral circulation to carbon dioxide. Nature (New Biol) 245: 187–188

    Google Scholar 

  18. Pickard JD, Walker V, Perry S, Smythe PJ, Eastwood S, Hunt R (1984) Arterial eicosanoid production following chronic exposure to a periarterial haematoma. J Neurol Neurosurg Psychiatry 47: 661–667

    PubMed  Google Scholar 

  19. Pickard JD, Walker V, Vile J, Perry S, Smythe PJ, Hunt R (1987) Oral Nimodipine reduces prostaglandin and thromboxane production by arteries chronically exposed to a periarterial haematoma and the antifibrinolytic agent tranexamic acid. J Neurol Neurosurg Psychiatry 50: 727–731

    PubMed  Google Scholar 

  20. Pickard JD, Walker V, Newton H, Smythe PJ, Perry S (1990) Effect of hydrocephalus on prostaglandins and thromboxane B2 in ventricular cerebrospinal fluid. Neurosurgery 27: 943–945

    PubMed  Google Scholar 

  21. Rodriguez y Baena R, Gaetani P, Foko G, Branzoli U, Paoletti P (1985) Cisternal and lumbar CSF concentration of arachidonate metabolites in vasospasm following subarachnoid haemorrhage from ruptured aneurysm. Surg Neurol 24: 428–432

    PubMed  Google Scholar 

  22. Rogriguez y Baena R, Gaetami R, Grignani G, Pacchiarini L (1987) Effect of nimodipine on arachidonic acid metabolites after subarachnoid haemorrhage. Acta Neurol Scand 76: 267–271

    PubMed  Google Scholar 

  23. Sasaki T, Marota S, Wakai S, Asano T, Sano K (1981) Evaluation of prostaglandin biosynthesis activity in canine basilar artery following subarachnoid injection of blood. J Neurosurg 55: 771–778

    PubMed  Google Scholar 

  24. Seifert V, Stolke D, Kaever V, Dietz H (1987) Arachidonic acid metabolism following aneurysm rupture. Surg Neurol 27: 243–252

    PubMed  Google Scholar 

  25. Suzuki S, Sobata E, Iwabuchi T (1981) Prevention of cerebral ischaemic symptoms in cerebral vasospasm with trapidil, an antagonist and selective synthesis inhibitor of thromboxane A2. Neurosurgery 9: 679–685

    PubMed  Google Scholar 

  26. Uski TK, Andersson KE (1984) Effects of prostanoids on isolated feline cerebral arteries. Acta Physiol Scand 120: 131–136

    PubMed  Google Scholar 

  27. Vinge E, Brandt L, Ljunggren B, Andersson KE (1988) Thromboxane B2 levels in serum during continuous administration of nimodipine to patients with aneurysmal subarachnoid haemorrhage. Stroke 19: 644–647

    PubMed  Google Scholar 

  28. Walker V, Pickard JD (1985) Prostaglandins, thromboxane, leukotrienes, and the cerebral circulation in health and disease. Adv Tech Stand Neurosurg 12: 3–90

    PubMed  Google Scholar 

  29. Walker V, Pickard JD, Smythe P, Eastwood S, Perry S (1983) Effects of subarachnoid haemorrhage on intracranial prostaglandins. J Neurol Neurosurg Psychiatry 46: 119–125

    PubMed  Google Scholar 

  30. White RP, Hagen AA (1982) Cerebrovascular actions of prostaglandins. Pharmacol Ther 18: 303–331

    Google Scholar 

  31. White RP, Robertson JT (1983) Comparison of piroxicam, meclofenamate, ibuprofen, aspirin, and prostacyclin efficacy in a chronic model of cerebral vasospasm. Neurosurgery 12: 40–46

    PubMed  Google Scholar 

  32. Wolfe LS, Coceani F (1979) The role of prostaglandins in the central nervous system. Ann Rev Physiol 41: 669–684

    Google Scholar 

  33. Zuccarello M, March JT, Schmitt G, Woodward J, Anderson DK (1989) Effect of the 21-aminosteroid U-74006F on cerebral vasospasm following subarachnoid haemorrhage. J Neurosurg 71: 98–104

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pickard, J.D., Walker, V., Brandt, L. et al. Effect of intraventricular haemorrhage and rebleeding following subarachnoid haemorrhage on CSF eicosanoids. Acta neurochir 129, 152–157 (1994). https://doi.org/10.1007/BF01406495

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01406495

Keywords

Navigation