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A Study of Plasma Atrial Natriuretic Peptide, Antidiuretic Hormone and Cerebral Vasospasms in Patients with Aneurysmal Subarachnoid Hemorrhage Kazuo Morinaga 1 , Seiji Hayashi 1 , Yukihiro Matsumoto 1 , Nobuyuki Omiya 1 , Junichi Mikami 1 , Mikiya Ueda 1 , Hiroyuki Sato 1 , Yoshitoshi Inoue 1 , Shuji Okawara 1 1Okawara Neurosurgical Hospital Keyword: subarachnoid hemorrhage , cerebral vasospasm , atrial natriuretic peptide(ANP) , antidiuretic hormone(ADH) pp.445-448
Published Date 1993/5/1
DOI https://doi.org/10.11477/mf.1406900480
  • Abstract
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The relationship between plasma atrial natriure-tic peptide (ANP) and antidiuretic hormone (AD H) both of which show high values after subarach-noid hemorrhage and cerebral vasospasm was stu-died.

The subjects were 23 patients who were admitted because of aneurysmal subarachnoid hemorrhage during three years from March, 1989 to March, 1992 and in whom plasma ANP and ADH levels could be determined over time. Cerebral vasospasm was evaluated by the finding of cerebral angiography, clinical symptoms, and presence or not of low den-sity areas on CT. Hyponatremia was defined as the serum sodium level of 130 mEq/l or less for two days or more.

Angiographical vasospasm was found in 17 pati-ents (85%), symptomatic vasospasm in 15 patients ( 65.2%), low density areas on CT in 9 patients (40.9%) and hyponatremia in 8 patients (34.8%). Symptomatic vasospasm was noted in 7 of the 8 pa-tients (87.5%) with hyponatremia, low density areas on CT in 4 patients (50%), the detection rate being high.

The plasma ANP and ADH levels were 76.7±32.1 pg/ml and 2.2±0.7 pg/ml respectively in the patients with symptomatic vasospasm against 38.3±21.3 pg/ ml and 2.4±0.6 pg/ ml respectively without symptomatic vasospasm, the plasma ANP level being significantly high in the patients with sym-ptomatic vasospasm (p<0.01).

The plasma ANP and ADH were 71.2±33.8 pg/ ml and 2.0±1.1 pg/ml respectively in the patients with low density areas on CT against 51.2±31.3 pg/ ml and 1.8±0.5 pg/ml respectively without low density areas on CT. The plasma ANP level tended to be high in the patients with low density areas, but no significant difference was found.

The plasma ANP level is significantly high in the patients with symptomatic vasospasm. Inadequate secretion of ANP causes hypotonic dehydration, which could be a factor to aggravate cerebral vasospasm.


Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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