The Cerebrospinal Fluid Thromboxane A2 And Prostaglandin I2 Levels In Patients With Severe Head Injury

Background: The aim of this study was to evaluate the levels of thromboxane A2 and prostoglandin I2 production in the ventricular cerebrospinal fluid in patients with severe head injury. Methods: CSF samples of the trauma group included 15 patients were obtained from an intraventricular catheter and in control group included 5 patients obtained while their shunt procedures were performing. Levels were measured using the corresponding kits for TXB2 and 6-keto PGF1a, metabolites of TXA2 and PGI2 respectively and CSF concentrations were measured during the following four time periods posttrauma: 6-10, 20-28, 40-56, and 64-74 hours. Results: When compared to the ventricular CSF control values, CSF concentrations of TXB2 were significantly increased in severe head injured-patients at all times post-trauma (p<0.0001). But there was a variation at the levels of 6-keto-PGF1a after trauma. Between 6 to 10 hours following trauma, a significant decline was noted (p<0.05). By the first day, levels were markedly increased, on average, three times those found in the control, but later there was a tendency to decline again. The TXA2/PGI2 ratio was studied. It remained high all times particularly at 6-10, 64,74 hours following trauma and closely related to the severity of injury and poor glasgow outcome score, being higher in more severe injury. Conclusion: These results suggest that, increased TXA2/PGI2 ratio was closely related to the brain injury severity and its outcome and therefore appears to be an important indicator of secondary brain damage. This study was done in Istanbul University, Cerrahpasa Medical School, Department of Neurosurgery