[A study on changes of plasma catecholamines concentrations and clinical prognosis in patients with ruptured...

The plasma catecholamine concentrations have generally been accepted as an index of sympathetic nervous activity in cardiovascular and neurologic disorders. Intracranial vessels are innervated by sympathetic nerve fibers. It is known that the plasma norepinephrine (NE) level is related to the sympathetic activity. Consequently, it is expected that the changes in sympathetic nervous function are accompanied by the release of NE at the sympathetic nerve terminals. There are many reports on the correlation between autonomic nervous system dysfunction and the presence of cerebral arterial spasm, systemic hypertension, ECG evidence of myocardial necrosis after subarachnoid hemorrhage. The present study was undertaken to know whether the measurement of plasma catecholamine concentrations could assess clinical status and have a prognostic value. We examined the plasma NE, epinephrine (E) and dopamine (DA) concentrations in thirty patients with ruptured intracranial aneurysms. Within 48 hours of admission, all patients were evaluated by Hunt & Hess grade depending on the clinical findings. Blood pressure estimations, ECG tracing and a blood sample were obtained. The clinical outcome of the patients was assessed on discharge. The "good" group consisted of patients who recovered completely or with minimal disabilities, and could lead independent lives. The blood samples were assayed by the high performance liquid chromatography. Plasma NE levels in the patients with ruptured intracranial aneurysms were significantly higher than those in the patients with brain tumors and non-neurological diseases. Plasma E levels in the patients with intracranial aneurysms were also higher than the concentrations in the patients with brain tumors and non-neurological diseases.(ABSTRACT TRUNCATED AT 250 WORDS)