The study of Serum Immunoglobulins and Complement C3 on Predictive Assessing Cerebral Vasospasm and Clinical Grade in Aneurysmal Subarachnoid Hemorrhage

Park, Sang Nam; Rhee, Dong Youl

Abstract

The immune system contributes to body defence mechanism, but sometimes show unfavorable immune disease. Cerebral vasospasm is a major problem in aneurysmal subarachnoid hemorrhage(SAH), but the pathogenesis is poorly understood. Some authors suggest cerebral vasospasm is one type of autoimmune vasculitis. In 35 patients(male 20, female 15) with aneurysmal SAH. the levels of serum immunoglobulin(Ig) G, A, M, E and complement C3(C3) were determined to analyze the relation among Igs, C3, cerebral vasospasm and clinical grade. The results were as follows : 1) Highly significant correlation presented between C3 level and cerebral vasospasm(p<0.001). 2) Highly significant correlation presented between IgA level and cerebral vasospasm(p<0.001). 3) Significant correlation showed IgA with admission grade(p<0.001) and outcome(p<0.01). 4) Significant correlation showed C3 with admission grade(p<0.05) and outcome(p<0.01). 5) Among the 4 groups(SAH without vasospasm, SAH within vasospasm, hypertensive intracranial hematoma(HICH), herniated intervertebral disc(HIVD)), significant statistical difference at the level of IgA and C3 with others is observed in the group 2. 6) In serial determination of C3 levels performed in 8 patients(group 1 and group 2), correlative alteration between C3 level and cerebral vasospasm was observed. From the above results, these findings suggest that IgA and C3 levels not only might be reflected the severity of the neurological insult but also provide the usefulness as a predictable marker of cerebral vasospasm in aneurysmal SAH.