The effects of acute cerebrovascular disease on serum and cerebrospinal fluid parameters K.J.B. Lamers*, H.C. Schoonderwaldt* *, M.V. Borkent* *, A.G.M. Theeuwes* * *, W.H. Doesburg* * *, and R.A. Wevers* Introduction The effects of acute cerebrovascular disease on the composition of Cerebrospinal Fluid (CSF) and serum components have been the subject of several studies, Usually these studies dealt with just one single aspect of serum and CSF biochemics such as in blood: CK, LD, ASAT and % antitrypsinel-6; in CSF: brain cell damage and release of in- tracellular substances from the Central Nervous System (CSF, ASAT, CK, LD) 68, disturbances in the intermediate metabolism of the CNS (CSF lactate, pyruvate) 9-12, Blood Brain Barrier (BBB) damage (albumin ratio, total protein in CSF) 13.14,immunological activity in CNS (IgG in- dex), alterations in neurotransmitter substances in CNS (CSF HVA, 5HIAA.) t5.16 Furthermore, the number of patients studied was low in general. The purpose of this study is to obtain a survey of the effects of acute cerebrovascular disease on all relevant parame- ters mentioned above in a sufficient number of patients, and the relation with different clinical stroke subgroups. Therefore, we have compared serum and CSF data from different stroke groups. The choice of these parameters was based on two preliminary studies in our clinic on smaller groups of stroke patients. Summary In order to evaluate the effects due to acute cerebrovascular disease on serum and cere- brospinal fluid (CSF) parameters, biochemical data from 312 patients were studied. In serum, CK, LD and al protein fraction showed a mo- derately close relationship to the severity of stroke. In CSF there could not be observed any relation between enzymatic activities (LD, ASAT, CK) and the severity of the disease. The same result was found for CSF protein and the ratio CSF albumin/serum albumin, para- meters which are indicative for Blood Brain Barrier (BBB) disturbances. Substances from the intermediate metabolism in the Central Nervous System (CNS) (lactate and pyruvate) were evidently raised in CSF and there was a clear relation between the CSF concentration and the severity of stroke. No indication for IgG immunoglobulin abnormalities in CSF was found. The concentration of neurotrans- mitter metabolite 5HIAA m CSF was signifi- cantly higher in (in)completed stroke than in Transient Ischaemic Attack. Key words: stroke, CSF enzymes, lactate, HVA. * Laboratory of Clinical Chemistry, * * Institute of Neurology, * * * Department of Statistical Consultation, Catholic University of Ni]megen, The Netherlands Address for correspondence and reprint requests: K.J.B. Lamers, Institute of Neurology, Catholic University of Nijmegen, P. O. Box 9101 6500 HB Nijmegen, The Netherlands Accepted 21.11.86 Clin Neurol Neurosurg 1987. VoL 89-1 23