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Myocardial creatine kinase isoenzyme in serum after subarachnoid haemorrhage
Insights
Elevated myocardial isoenzyme of creatine kinase (MB CK) in subarachnoid hemorrhage patients may indicate cerebral ischemia. This finding could aid in surgical timing and prognosis assessment.
Area of Science:
- Neurology
- Cardiology
- Biochemistry
Background:
- Subarachnoid hemorrhage (SAH) can lead to serious neurological complications.
- Cardiac involvement following SAH is recognized but not fully understood.
- Creatine kinase isoenzymes, particularly MB CK, are markers of cardiac injury.
Purpose of the Study:
- To investigate the presence and significance of myocardial isoenzyme of creatine kinase (MB CK) in patients with acute subarachnoid hemorrhage.
- To explore the association between elevated MB CK levels and neurological complications like cerebral ischemia and arterial spasm.
- To evaluate the potential of MB CK as an early indicator for surgical intervention and long-term prognosis in SAH patients.
Main Methods:
- Serum samples were collected from 16 patients with acute subarachnoid hemorrhage.
- Levels of myocardial isoenzyme of creatine kinase (MB CK) were measured in patient sera.
- Cerebral angiography was performed to detect intracranial arterial spasm.
- Neurological deficits were assessed and correlated with MB CK levels and angiographic findings.
Main Results:
- Elevated MB CK levels were detected in the serum of 7 out of 16 patients (43.75%) with acute subarachnoid hemorrhage.
- All patients with elevated MB CK showed either intracranial arterial spasm or a focal reversible neurological deficit.
- These deficits were not attributable to direct pressure from hematoma or aneurysm.
Conclusions:
- The presence of MB CK in SAH patients may serve as a biomarker for cerebral ischemia.
- MB CK levels could be valuable in optimizing surgical timing and predicting long-term prognosis.
- Sympathetic nervous system activation might be a common pathway linking myocardial MB CK release and intracranial arterial spasm in SAH.
Abstract:
The myocardial isoenzyme of creatine kinase (MB CK) has been demonstrated in the serum of seven of 16 patients presenting with acute subarachnoid haemorrhage. All patients with elevated MB CK levels exhibited at some stage either intracranial arterial spasm as demonstrated by cerebral angiography, or a focal reversible neurological deficit not due to direct pressure by either intracranial haematoma or aneurysm. The presence of MB CK isoenzymes in sera of patients with subarachnoid haemorrhage may be an index of cerebral ischaemia, and may thus be of value in determining optimal timing of surgery or, ultimately, the long-term prognosis. Changes in the sympathetic nervous system may be a common factor producing both MB isoenzyme release from the myocardium and intracranial arterial spasm.