Dynamics of nitric oxide dependant oxidative stress in acute stage of ischemic stroke
Fifty-eight patients with acute ischemic stroke have been studied. The basic neurological impairment was assessed with the National Institute of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS). The patients were stratified by stroke severity into 2 groups: 1--with severe stroke (GCS> 9; NIHSS > 15) and 2--with stroke of moderate severity (GCS = 14-15; NIHSS = 10-15). Visualization of ischemic injury was performed by conventional Magnetic Resonance Imaging (MRI) 24 hours after stroke onset. Nitric oxide (NO) levels were measured by Electron Paramagnetic Resonance (EPR) method and NO2 and superoxidedismutase (SOD) levels were defined by spectrophotometer. Comparing to controls, intensive EPR signals for free NO were found in the groups of patients during 48 hours after stroke onset, though no between-group differences were detected. In group 2, CSF SOD and NO2 levels were significantly higher than in group 1 and controls. There was a significant negative correlation between initial NO2 CSF levels and ischemic lesion size as well as functional outcome 1 month after stroke onset. Thus, CSF NO2 levels in acute stage of ischemic stroke can be considered as an important predictor of the disease course and functional outcome.