Increase in jugular levels of polymorphonuclear neutrophil elastase in patients with acute cerebral infarction.

To elucidate the involvement of activated polymorphonuclear neutrophil (PMN) proteolytic activity in the pathophysiology of cerebrovascular stroke, we measured internal jugular venous and femoral arterial levels of PMN elastase in 6 patients with acute stroke from the day onset (day 0) to 7 days after onset (day 7). Two patients with cerebral infarction demonstrated markedly elevated of PMN elastase in the jugular blood (730 and 1320 micrograms l-1, respectively), but not in the blood (203 and 205 micrograms l-1, respectively) on day 2. Both patients manifested signs of hemorrhagic infarction early on day 2. On day 4, the increased levels of jugular elastase returned to the normal range (< 250 micrograms l-1 in both patients. In contrast, none of the 4 patients with intracerebral hemorrhage demonstrated increased levels of PMN elastase in either the jugular or the arterial blood from days 0 to 7. The present study demonstrated a temporary but significant increase in jugular PMN elastase in patients with cerebral infarction, especially shortly after hemorrhagic infarction.