Norepinephrine in cerebrospinal fluid of patients with cerebral vasospasm

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Abstract
The content of norepinephrine (NE) in the ventricular, basal cisternal and lumbar was determined in 19 patients with ruptured cerebral aneurysms at different intervals according to the presence or absence of vasopasm. Twelve were operated on within 3 days after subarachnoid hemorrhage (SAH), prior to the occurrence of vasospasm. Postoperatively, CSF was continuously drained from a basal cistern or lateral ventricle. Norepinephrine was assayed by the highly sensitive automated fluorometric method. The concentration of NE increased in all sites of CSF sampling along with the appearance of vasospasm. Above all, the cisternal CSF of patients with vasospasm contained significantly higher NE (0.246 .+-. 0.049 ng/ml, mean .+-. SEM [standard error of the mean]) compared to those without vasospasm (0.075 .+-. 0.001 ng/ml) (P < 0.001). Since this increase cannot be considered to be high enough locally to constrict cerebral arteries, this might be only a secondary phenomenon due to release of NE into CSF from various sources in the brain.