[Prostaglandin D2 in subarachnoid hemorrhage. Biological and diagnostic implications]

The concentration of PG D2 (a prostanoid with demonstrated vasoconstrictor activity on human cerebral arteries was studied in the cerebrospinal fluid of 7 patients admitted for subarachnoid aneurysmal hemorrhage. CSF samples were sequentially obtained at different intervals following the hemorrhage and the PG D2 concentration was detected with radioimmunological assay. Four patients developed vasospasm leading to neurological deterioration. PG D2 concentrations varied from 0.21 to 1.09 mg/ml. The highest CSF PG D2 concentrations were seen 24-48 hours after the hemorrhage in three patients, who subsequently died due to resumption of bleeding. In the four cases with angiographically demonstrated vasospasm a peak in PG D2 concentration could be observed corresponding to the clinical appearance of neurological deterioration. In the three cases without a neurological finding of vasospasm, PG D2 concentrations tended to be stable. Serial monitoring of arachidonic acid metabolites having different vasoactive actions on the cerebral arterial wall could be of great interest as a clinical and biological marker useful in the management of subarachnoid hemorrhage.