Plasma And Cerebrospinal Fluid Homocysteine, Nitric Oxide And
Malondialdehyde Levels In Acute Ischemic Stroke: Possible Role Of Free
Radicals In The Development Of Brain Injury
Aim: Free radical mechanisms may play an important role in brain
ischemia / reperfusion injury. The generation of reactive oxygen
species by homocysteine (Hcy) or nitric oxide (NO) metabolism might be
involved in the induction of lipid peroxidation, as indicated by
malondialdehyde (MDA) formation. The purpose of this study was to
investigate the behavior of Hcy, NO and MDA in plasma and cerebrospinal
fluid (CSF) within 4 days after ischemic stroke onset. Methods: The
levels of NO, Hcy and MDA were determined in plasma and CSF on the 3rd
or 4th days after the onset of ischemic stroke in 29 patients (12 men
and 17 women) and in 13 healthy controls (6 men and 7 women) of
comparable age and gender. Results: The plasma MDA, NO and Hcy levels
were significantly higher in the stroke patients, while mean MDA, NO
and Hcy levels in CSF showed a significant increase in the cases as
compared to controls (p<0.01). There were no gender-specific
differences in the plasma or CSF MDA, NO and Hcy concentrations. A
significant negative correlation was found between duration of diabetes
with CSF NO (r=-0.63, p<0.001). The low Glasgow Coma Scale (GKS) was
negatively correlated with lethal outcome, (r=-0.76, p<0.001), but
it did not correlate significantly with any of the measured parameters.
Conclusion: These data support that free radical mechanisms may play
a role in the development of brain injury following ischemic stroke. It
was suggested that the elevated Hcy may be an important risk factor for
acute ischemic cerebral injury