Cerebrospinal fluid ferritin in patients with cerebral infarction or bleeding

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Abstract
By the use of a radioimmunoassay, ferritin was detected in the CSF of apparently healthy individuals at a mean concentration of 5.1 arb U/l [arbitrary units per l], i.e., a level about 5% of the mean normal serum-ferritin concentration. Patients (14) with acute cerebrovascular stroke or transient ischemic attacks (1 case) were followed by serial determinations of CSF-ferritin during 2 wk or more from the onset of symptoms. After cerebral stroke, all patients exhibited an increase of CSF-ferritin with peak levels between 4-6 days from admission. In the 3 patients showing cerebral bleeding in the highest peak, CSF-ferritin concentrations: (mean value 249 .+-. 65 (SEM [standard error of mean]) arb U/l) were found. The mean peak CSF-ferritin was 28 .+-. 11 arb U/l in the patients with cerebral infarction without signs of bleeding. In 7 patients, CSF-ferritin returned to the control range after 2 wk. The extent of the rise of ferritin in CSF was not explained by damaged blood-CSF barrier. The increment of ferritin in CSF of patients with cerebrovascular lesions may reflect an inflammatory response within the brain, possibly mediated by macrophages.