Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Studies on CSF and Serum Enzymes in Acute Phase of Cerebrovascular Accident
M. FurugenT. Tamura
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1978 Volume 15 Issue 3 Pages 235-244


Fructose-1, 6-diphosphate aldolase (ALD) and lactic dehydrogenase (LDH) in cerebrospinal fluid (CSF) and serum were measured during acute phase of cerebral bleeding (23 cases), cerebral infarction (16 cases) and subarachnoid hemorrhage (11 cases).
The results were as follows:
1) There was a significant elevation of both ALD and LDH of CSF and serum in cerebral bleeding, serum LDH in cerebral infarction, and ALD and LDH of CSF in subarachnoid hemorrhage compared with the normal control. ALD and LDH of CSF were significantly higher in cerebral bleeding than in cerebral infarction, while no significant difference of serum enzymes was found between the two diseases.
2) The patients with cerebral bleeding were divided into two groups according to bloody or clear CSF. In the clear as well as the bloody CSF group, ALD and LDH of CSF were significantly greater than in cerebral infarction. In serum, LDH activity of the bloody group was higher than cerebral infarction.
3) In the patients with cerebral bleeding, ALD and LDF of CSF was significantly higher in the severe cases compared with mild cases, while this difference was not observed in serum enzyme.
4) Enzyme activities of CSF and serum in the patients with cerebral bleeding were increased and reached the peak value within seven days, then they decreased gradually. The duration of elevation in CSF enzymes was longer than that of serum enzymes and they remained still above normal value two weeks after the attack.
5) A positive correlation between CSF-ALD and CSF protein content or CSF-ALD and -LDH and cell counts was observed in the whole patients and in the patients. However no such correlation was seen in the patients with cerebral infarction or subarachnoid hemorrahge.
6) There was a positive correlation of both ALD and LDH between CSF and serum in the whole patients and of ALD in cerebral infarction, but not in cerebral bleeding or subarachnoid hemorrhage.
These findings suggest that a measurement of ALD and LDH activity of CSF is useful for the differential diagnosis and the prediction of the prognosis of cerebrovascular accident. Further studies are necessary, however, to elucidate a mechanism of the elevation of CSF or serum enzymes.

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