Journal
ACTA NEUROLOGICA SCANDINAVICA
Volume 115, Issue 4, Pages 254-259Publisher
WILEY
DOI: 10.1111/j.1600-0404.2006.00741.x
Keywords
albumin; beta-2-microglobuline; blood-brain barrier; cerebrospinal fluid; inflammation; spinal anaesthesia; stress
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Objective- To study changes in cerebrospinal fluid (CSF) protein markers of blood-CSF barrier integrity and immunological reactions during surgical stress. Methods- Thirty-five patients without neurological or psychiatric disorders undergoing knee replacements had CSF and serum samples drawn from spinal and arterial catheters before, 3 h after and the morning after surgery. Results- Serum albumin decreased during surgery and CSF albumin decreased during and after surgery, and, as a consequence, the CSF/serum albumin ratio decreased significantly during the study period, especially after the intervention. In contrast, CSF concentrations of beta-2-microglobuline (beta 2M) increased significantly during surgery and remained high. The CSF general marker beta-trace protein (beta TP) remained unchanged. Conclusins- Central nervous system protein reactions to a non-neurological surgical intervention include sharply decreased permeability of albumin into the CSF and signs of intrathecal inflammatory activity.
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