The stimulation of vascular smooth muscle oxidative metabolism by CSF from subarachnoid haemorrhage patients increases with fisher and WFNS grades

The purpose of this paper is to present an in vitro method for examining cerebral vasospasm after subarachnoid haemorrhage (SAH) which correlates to the patients' condition. The Oz consumption of the porcine carotid artery was monitored, using an oxygen electrode, after exposure to cerebrospinal fluid (CSF) from patients who had a SAH. The vessels were exposed to CSF from SAH patients at a 1 in 30 dilution. Force measurements were carried out using freeze-dried CSF, reconstituted in the organ bath equivalent to undiluted CSP. These observations were then compared to the patients' condition. We divided the patient CSF samples into those that stimulated oxygen consumption above 0.4 muM/min/g dry wt, and those that did not. It was found that there was a correlation between the stimulation of oxygen consumption and the Fisher grade as well as the World Federation of Neurosurgeons Grading System (WFNS) for the patients. Of the CSF tested. 24 stimulated oxygen consumption above our cut off, and 8 did not (0.84 +/- 0.34, n = 24 compared with the rate of 0.27 +/- 0.1 mu mol/min/g dry wt, respectively; SD n = 8) at 180 minutes. We then examined the Fisher Grades of these two groups, the results were 3.21 +/- 0.88 vs 2.25 +/- 0.83 respectively (SD p less than or equal to 0.01). When examining the WFNS System we found a similar difference between the groups that stimulated respiration and those who did not (WFNS Grades of 2.64 +/- 1.1 vs. 1.43 +/- 0.53; p less than or equal to 0.01). The observed stimulation of oxygen consumption also correlated with tension generation in vitro. The CSF from subarachnoid haemorrhage patients stimulates the oxygen consumption of the porcine carotid artery. This stimulation correlated to the WFNS and Fisher Grades of the patients and can be performed using 1:30 dilution of CSF. We conclude that the metabolic changes that occur in the vessels during vasospasm are important parameters for assessing cerebral vasospasm.