Comparison of thiol/disulfide, total oxidant status, total antioxidant status and nitric oxide levels in cerebrospinal fluid and blood in patients with aneurysmatic subarachnoid hemorrhage; prospective, controlled work

Thiol/disulfite, total oxidant status(TOS), total antioxidant status(TAS) and nitric oxide(NO) were measured in cerebrospinal fluid and blood in these aneurysmatic subarachnoid hemorrhage patients and compared with normal subjects. The study group included 38 patients who were hospitalized in Gaziantep University Faculty of Medicine, Neurosurgery Clinic, had aneurysmatic subarachnoid hemorrhage during the examinations and were operated for the first 48 hours. Cerebrospinal fluid(CSF) and blood samples taken during the operation of this unit formed the working group. The control group consisted of patients who were operated on under spinal anesthesia in the operating room of Gaziantep University Faculty of Medicine, who did not have an additional hospital in other respects (n=40), blood and CSF samples taken during the spinal anesthesia procedure were used in our study. In the study, both groups included TAS, TOS, oxidative stress index (OSI), levels of natural thiol, total thiol and disulfide, natural thiol/total thiol ratio, dynamic disulfide/total thiol ratio, dynamic disulfide/natural thiol ratios measured and compared in blood and CSF samples. When compared to the control group, TAS decreased (P=0.0143), TOS (P=0.6264) and OSI did not change significantly (P=0.8388) in the serum of the study group. While natural thiol (P<0.0001) and total thiol (P=0.0014 ) levels decreased in the study group, disulfide levels (P<0.0001) increased significantly. While the natural thiol/total thiol ratio decreased (P<0.0001) in patient serum, the dynamic disulfide/total thiol ratio (P<0.0001) and dynamic disulfide/natural thiol ratio (P<0.0001) increased significantly. Patient serum NO levels were also significantly increased (P<0.0001). There was no significant change in CSF in all measured parameters (P>0.05). Our study is unique in that these parameters were studied simultaneously in blood and CSF samples. As a result, it was determined that oxidative stress and NO levels increased in the serum of the patients. We hope that it will contribute to the literature on the understanding of the mechanism of early tissue damage due to subarachnoid hemorrhage and the role of oxidative stress markers in preventing other related complications.