Concentration of 3′,5′ cyclic adenosine monophosphate in ventricular CSF of patients following severe head trauma

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Abstract
CSF from the lateral ventricle of patients without disturbance of sensorium or intracranial pressure contains 15-30 nM cyclic(c)AMP. The concentration of this cyclic nucleotide was measured by radioimmunoassay in 133 samples of CSF from the lateral ventricle of 26 patients who were comatose following acute head trauma for periods up to 40 days. Concentration of CSF cAMP in diminishing coma Grades V, IV, III, II and I was 1.5 .+-. 0.1 nM; 1.24 .+-. 0.34 nM; 3.14 .+-. 0.7 nM; 10.06 .+-. 3.47 nM; and 13.36 .+-. 1.38 nM, respectively. After the sensorium cleared (coma Grade 0), cAMP was 22.0 .+-. 1.7 nM. The correlation between the grade of coma and cAMP concentration was -0.80 (P > 0.01). Alteration in the level of consciousness following head trauma is apparently associated with a disturbance of cAMP metabolism within the CNS. Possible mechanisms explaining this observation and therapeutic implications are discussed.