Cerebrospinal fluid atrial natriuretic factor in intracranial disease

Michael N. Diringer, Jeffrey Kirsch, Paul W. Ladenson, Cecil Borel, Daniel F. Hanley

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

We tested the hypothesis that the concentration of atrial natriuretic factor in the cerebrospinal fluid is an indicator of brain injury in patients with intracranial disease. Atrial natriuretic factor concentration was measured in 72 samples of cerebrospinal fluid from 28 patients with intraventricular drains and in nine samples from outpatient controls undergoing diagnostic lumbar puncture. Levels were correlated with diagnosis; systemic fluid administration; concentration of atrial natriuretic factor in the plasma; intracranial pressure; sodium, glucose, and protein concentrations, osmolality, and cell count in the cerebrospinal fluid; sodium concentration in the serum; and hemodynamics. Atrial natriuretic factor concentration was highest in cerebrospinal fluid from patients with intracerebral hematoma, followed by those with obstructive hydrocephalus and subarachnoid hemorrhage (19±2, 13±3, and 8±2 pg/ml, respectively); atrial natriuretic factor concentration was <4 pg/ml in the controls. Patients treated with fluid restriction had significantly higher atrial natriuretic factor levels than those receiving maintenance or high-volume fluids (16±3, 8 ±2, 10±l pg/ml, respectively). The concentration of atrial natriuretic factor in the plasma was significantly elevated in patients with intracerebral hematoma and subarachnoid hemorrhage (155 ±38 and 92±20 pg/ml, respectively) and did not correlate with fluid administration or the concentration of atrial natriuretic factor in the cerebrospinal fluid. Neither cerebrospinal fluid nor plasma concentrations of atrial natriuretic factor correlated with intracranial pressure; cerebrospinal fluid sodium, glucose, or protein concentrations, osmolality, or cell count; serum sodium concentration; or hemodynamics. We conclude that the concentration of atrial natriuretic factor in the cerebrospinal fluid is a nonspecific indicator of brain injury. Cerebrospinal fluid levels of atrial natriuretic factor may be elevated in response to dehydration therapy. Elevated plasma levels of atrial natriuretic factor suggest a central mechanism modulating cardiac release.

Original languageEnglish (US)
Pages (from-to)1550-1554
Number of pages5
JournalStroke
Volume21
Issue number11
StatePublished - 1990
Externally publishedYes

Fingerprint

Atrial Natriuretic Factor
Cerebrospinal Fluid
Sodium
Intracranial Pressure
Subarachnoid Hemorrhage
Hematoma
Osmolar Concentration
Brain Injuries
Cell Count
Hemodynamics
Glucose
Spinal Puncture
Cerebral Hemorrhage
Hydrocephalus
Serum
Dehydration
Proteins
Outpatients
Maintenance

Keywords

  • Cerebrospinal fluid
  • Hydrocephalus
  • Natriuretic peptides, atrial
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing
  • Neuroscience(all)

Cite this

Diringer, M. N., Kirsch, J., Ladenson, P. W., Borel, C., & Hanley, D. F. (1990). Cerebrospinal fluid atrial natriuretic factor in intracranial disease. Stroke, 21(11), 1550-1554.

Cerebrospinal fluid atrial natriuretic factor in intracranial disease. / Diringer, Michael N.; Kirsch, Jeffrey; Ladenson, Paul W.; Borel, Cecil; Hanley, Daniel F.

In: Stroke, Vol. 21, No. 11, 1990, p. 1550-1554.

Research output: Contribution to journalArticle

Diringer, MN, Kirsch, J, Ladenson, PW, Borel, C & Hanley, DF 1990, 'Cerebrospinal fluid atrial natriuretic factor in intracranial disease', Stroke, vol. 21, no. 11, pp. 1550-1554.
Diringer MN, Kirsch J, Ladenson PW, Borel C, Hanley DF. Cerebrospinal fluid atrial natriuretic factor in intracranial disease. Stroke. 1990;21(11):1550-1554.
Diringer, Michael N. ; Kirsch, Jeffrey ; Ladenson, Paul W. ; Borel, Cecil ; Hanley, Daniel F. / Cerebrospinal fluid atrial natriuretic factor in intracranial disease. In: Stroke. 1990 ; Vol. 21, No. 11. pp. 1550-1554.
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