Serum complements as indicator for predicting vasospasm and its severity after aneurysmal subarachnoid hemorrhage

We investigated serum complements (CH50, C3, C4) after aneurysmal subarachnoid hemorrhage in 21 patients over a 2 to 3-week period. For a control, we performed the same examination on patients with non-subarachnoid hemorrhage such as hypertensive intracerebral hemorrhage. There were no remarkable changes of serum complements in the control patients. Preoperative grading (by Hunt and Hess) was well correlated with the C4 level but not the C3 level. C4 levels in patients without symptomatic vasospasm did not change markedly after subarachnoid hemorrhage over investigation. They decreased severely, however, in patients with severe vasospasm and major neurological deficits. The patients with mild symptomatic vasospasm and no major neurological deficits showed transient decreases of C4 levels 5 to 10 days after subarachnoid hemorrhage. Our data showed that sequential measurements of serum complements C4 after subarachnoid hemorrhage was useful for choosing the method of therapy and for predicting the prognosis of aneurysmal patients after subarachnoid hemorrhage.