First 5-days follow-up and correlation study between urinary cysteinyl leukotrienes and edema values in primary spontaneous supratentorial intracerebral hemorrhage

Abstract

Background: After intracerebral hemorrhage cysteinyl leukotrienes (C4, D4, E4) are synthetisized in the contact brain parenchyma-extravasated blood and participate in producing of edema formation. The study aim is a 5-days follow up (admittance/3th day/5th day) of urinary cysteinyl leukotrienes, hematoma and edema volume in patients with primary spontaneous supratentorial intracerebral hemorrhage and to determine the relationship: edema/haematoma and edema/leukotrienes. Methods: An enzyme immunoassay for leukotrienes measuring in the urine samples from 62 patients with hemorrhage during the first 5 days (admittance/3th day/5th day) and 80 health controls is used. Hematoma and edema volume is visualised and measured by computed-tomography. Results: Admission values of leukotrienes were significantly higher in the hemorrhagic patients (min = 268.61; max = 5787.36; mean = 1842.20 ± 1413.19 pg/ml/mg creatinine) versus control subjects (min = 297.8; max = 1684.2; mean = 918.6 ± 332) (p 0.05). The edema (mean: 12.86 ± 13.52; 22.38 ± 21.10; 28.45 ± 29.41 cm3 ) showed very high significance (p 0.05) of moderate strength is found between edema and hematoma; and significant positive correlation (r = 0.6; p 0.05) at admittance, r = - 0.05 (p > 0. 05) on the 3th day (nonexistence of linear correlation, the sign minus presents their tendency for the opposite movement in their values) and r = 0.2 (p > 0.05) on the 5th day are found (positive linear nonsignificant correlation of slight strength). Conclusion: Significant urinary leukotrienes excretion (a brain capacity for significant leukotreienes synthesis) and significant edema progression versus constant haematoma are found. The edema size followed the hematoma size of moderate extent. The edema showed an inverse dependence of the leukotrienes (a tendency for opposite movement of their values), the high leukotrienes values at admittance bring to greater edema volume on the third/the fifth day, respectively. Elevated cysteinyl leukotrienes synthesis and the elevated edema could point to cause-effective relationship between them establishing the leukotrienes as an edema promotive-factor in intracerebral haemorrhage.

Keywords

• Intracerebral hemorrhage
• brain edema
• cysteinyl leukotrienes