Cerebrospinal fluid creatine phosphokinase in acute subarachnoid hemorrhage.

The author measured the level of creatine phosphokinase (CPK) in 35 cerebrospinal fluid (CSF) specimens from 30 patients with acute subarachnoid hemorrhage, and correlations were sought with 17 other clinical and laboratory parameters. Elevations of CSF CPK have no diagnostic specificity. However, they do dhow a statistically significant correlation with the existence of any destructive process in cerebral tissue (hydrocephalus, infarction, intraparenchymal hemorrhage, or intraventricular clot). Yet arterial spasm without infarction does not raise the CSF CPK level. During the preoperative management of ruptured aneurysms and vascular malformations, a significant elevation of the CSF CPK level can thus provide a clue to the presence or significance of one or more of these destructive processes.