Cerebrospinal fluid markers of disturbed brain cell metabolism in patients with stroke and global cerebral ischemia

Abstract

Adenylate kinase activity was found in 32 of 34 CSF samples from 21 patients with stroke and 7 patients with global cerebral ischemia (GCI). The light absorbance values of the spectrum 400-650 nm revealed the scanty occurrence of Hb products in the CSF in some patients. There was no correlation between the absorbance values at 415 nm, reflecting oxyhemoglobin, and the adenylate kinase activities. A main contribution to the adenylate kinase activity in CSF by leakage of this enzyme from erythrocytes could be ruled out. Instead increased leakiness of the brain cells, having an impaired metabolism due to insufficient supply of O2 and glucose, was the most plausible cause of the findings. The quotient between the adenylate kinase activity and the light absorbance at 415 nm seemed to reflect the extent of ischemically deranged brain tissue in the GCI patients, while the CSF-lactate values were not correlated with the clinical outcome. Glutathione, an intracellular tripeptide, was found more often in the CSF from GCI patients than from stroke patients.