Cerebrospinal fluid CK enzyme and CK isoenzymes in the outcome prognosis of cerebrovascular disease.

The article presents the results of the analysis of total CK enzyme activity and CK isoenzymes in the cerebrospinal fluid of 148 patients with acute stroke, treated at the Intensive Care Unit of the Department of Neurology and Department of Neuropathology of the Clinical Hospital Center Rebro. The aim of the study was to determine the reliability of the applied methods in the prognosis of the outcome of cerebrovascular diseases. Greatly increased total CK enzyme activity is more frequently encountered in patients with ICH than in those with ISI. Great elevation of total CK activity can be considered a bad prognostic sign in patients with ICH, while in those with ISI only moderately increased total CK enzyme activity can be regarded as a bad prognostic sign. The greatest incidence of pathological CK isoenzyme profile, that is the presence of both MM and BB fractions together, was found in the group of patients who died with ICH, while the greatest frequency of BB fraction alone was observed in the group of patients who survived with ISI. In the group of the deceased with ISI the greatest frequency was that of MM and BB fractions together. Therefore, the occurrence of BB fraction alone can be considered a good prognostic sign, while the occurrence of MM and BB fractions together a bad one. The presence of MM and BB fraction together, as well as the simultaneous presence of all three fractions of isoenzymes, are most frequently associated with elevated total CK enzyme activity. The occurrence of BB isoenzyme fraction alone is most frequently accompanied by normal value of total CK activity, rarely with slightly to moderately, and very rarely with greatly increased total CK enzyme activity. The determination of total CK activity and of CK isoenzyme profile is performed by means of two complementary investigations which should be performed simultaneously.