Abstract
Autonomic nervous function is assumed to be deranged in the acute stage of cerebrovascular diseases (CVD), but no systematic evaluation of the function has ever been attempted in the disease. The purpose of the present study was to investigate the time course of the noradrenergic nervous function in patients with CVD from the view point of circulatory catecholamines.
Nineteen patients had occlusive CVD which consisted of 13 hemispheric and 6 brainstem infarctions. Hemorrhagic CVD consisted of 9 intracerebral and 10 brainstem hemorrhages. Blood samples were obtained serially from the onset up to 60 days after the stroke. Plasma catecholamines were measured with the method of high speed liquid chromatography. In hemorrhagic CVD without ventricular rupture, both plasma norepinephrine and epinephrine remained within normal range until 30 hours after the attack, then started to increase reaching an initial peak on the third day which was followed by second peak on the twelfth day. The mean curves of the time course for plasma catecholamines in occlusive CVD had two peaks, the first one on the third day and the second one on the eleventh day, similar to the peaks observed in hemorrhagic CVD. In the patients with ventricular rupture both catecholamine values were markedly elevated and reached to their highest values immediately after the onset of the disease. All patients with plasma norepinephrine over 800 pg/ml expired in the acute stage. The increase of plasma norepinephrine or epinephrine induced by head-up tilting reached its maximal level on the eleventh day, corresponding to the second peak of the basic catecholamine levels.
The above results confirmed the clinical assumption that the autonomic nervous function is deranged in the acute stage of stroke.
