Abstract
It is well known that superoxide dismutase (SOD) acts on free radical reactions at their early stage as a scavenger against superoxide. On 17 cases with ruptured intracranial aneurysms, we studied the.changes of SOD activities in the cerebrospinal fluid. All patients were operated on within four days after the onset, and CSF samples were taken from both the lateral ventricle and the chiasmatic cistern for seven to ten days after surgery. The results were compared with the changes of the amount of lipid peroxide in CSF during the same period and with the presence or absence of postoperative vasospasms. From the patterns of the changes of SOD activities, patients were divided into three groups; in seven. cases, the level of SOD activities in both ventricular and cisternal CSF started to decrease on the third clay after the onset and fell to almost null on the fourth day and thereafter (severly decreased group), in eight cases, SOD activities remained within normal ranges thoughout the period (nornal range group), in the remaining two, the level of SOD activities decreased moderately either in ventrcular or cisternal CSF (moderately decreased group). In the severely decreased group, all but one had a large amount of lipid peroxide in CSF on the fourth day and afterward. They showed an evidence of angiographically severe vasospasm and clinical deterioration. In all patients in the normal range group, the level of lipid peroxide in CSF was low throughout the period. They had good clinical courses and no postoperative angiospasm. One patient in the moderately decreased group had a high level of lipid peroxide while the,other's remained low. Both showed angiographic vasospasm without developing clinical symptoms.
It was concluded that superoxide dismutase in CSF as a scavenger might play an important role in protecting cerebral vessels against vasospasm in patients with ruptured intracranial aneurysms.
