The implication of the steroids estradiol, progesterone and testosterone in cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) has not been comprehensively assessed. In rodents, studies suggested beneficial effects of steroids on cerebral vasospasm after experimental SAH. Studies in humans are warranted, however, a general dilemma of human studies on neuroactive substances is that the brain is not directly accessible and that concentrations in the periphery may not adequately parallel concentrations in the central compartments. In the present study, concentrations of estradiol, progesterone and testosterone in serum and cerebrospinal fluid (CSF) of patients with aSAH were determined. Blood flow velocities in cerebral arteries were measured by transcranial Doppler sonography (TCD). The aim of this study was to evaluate the correlations between the cerebral blood flow velocities and levels of estradiol, progesterone and testosterone in CSF and serum. Samples of serum and CSF of 42 patients with aSAH were collected concomitantly daily or every other day via the arterial line and the external ventricular drainage for two weeks after the hemorrhage. Blood flow velocities in the cerebral arteries were determined by TCD. Total estradiol, progesterone and testosterone concentrations were measured by electro-chemiluminescence immunoassay. The strength of correlation was assessed by Spearman’s rank correlation coefficient. The correlation analysis revealed very weak correlations between cerebral blood flow velocities and concentrations of estradiol, progesterone and testosterone levels in both compartments with correlation coefficients below 0.2. In humans with aSAH, merely very weak correlations between flow velocities in cerebral arteries and concentrations of estradiol, progesterone and testosterone in serum and CSF were demonstrated. These results suggest a limited influence of the respective steroids on cerebral vascular tone although vasodilatory effects were described in rodent studies. Thus, the implication of steroids in processes of neurological deterioration warrants further clarification.

中文翻译：

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动脉瘤性蛛网膜下腔出血患者血清和脑脊液中雌二醇、孕酮和睾酮的浓度与经颅多普勒血流速度弱相关

类固醇雌二醇、孕酮和睾酮对动脉瘤性蛛网膜下腔出血 (aSAH) 后脑血管痉挛的影响尚未得到全面评估。在啮齿类动物中，研究表明类固醇对实验性 SAH 后的脑血管痉挛有益。人类研究是有必要的，然而，人类对神经活性物质研究的普遍困境是大脑不能直接进入，并且外围的浓度可能无法充分平行中央区室的浓度。在本研究中，测定了 aSAH 患者血清和脑脊液 (CSF) 中雌二醇、孕酮和睾酮的浓度。通过经颅多普勒超声 (TCD) 测量脑动脉中的血流速度。本研究的目的是评估脑血流速度与脑脊液和血清中雌二醇、孕酮和睾酮水平之间的相关性。42 名 aSAH 患者的血清和脑脊液样本在出血后的两周内每天或每隔一天通过动脉和心室外引流收集。脑动脉中的血流速度由 TCD 确定。通过电化学发光免疫测定法测量总雌二醇、孕酮和睾酮浓度。相关强度由斯皮尔曼等级相关系数评估。相关性分析显示脑血流速度与雌二醇浓度之间的相关性非常弱，两个区室中的黄体酮和睾酮水平，相关系数低于 0.2。在患有 aSAH 的人类中，仅证明了脑动脉流速与血清和脑脊液中雌二醇、孕酮和睾酮浓度之间的相关性非常弱。这些结果表明，尽管在啮齿动物研究中描述了血管舒张作用，但相应的类固醇对脑血管张力的影响有限。因此，类固醇在神经功能恶化过程中的意义需要进一步澄清。这些结果表明，尽管在啮齿动物研究中描述了血管舒张作用，但相应的类固醇对脑血管张力的影响有限。因此，类固醇在神经功能恶化过程中的意义需要进一步澄清。这些结果表明，尽管在啮齿动物研究中描述了血管舒张作用，但相应的类固醇对脑血管张力的影响有限。因此，类固醇在神经功能恶化过程中的意义需要进一步澄清。