Complement system in acute hemorrhagic stroke

Purpuse: The role of the complement system in cerebrovascular events has recently been discussed with ever-increasing demand. Material and method: In hemorhagic stroke, the complement system interacts with the coagulation system and inflammation and it shows changes. In this study we studied whether the complements components, namely C<inf>3</inf>,C<inf>4</inf> serum levels, serum Ig levels (A,G,M), number of leukocytes, and fibrinogen levels showed any differences from the control group and studied the time based progress of these parameters and their relations with the clinical and CT parameters. In the study we covered 87 acute hemorrhagic stroke patients and 46 controls who were admitted in our clinic between April and November 1999. Patients were selected into the study with the conditions of being in the initial three days of acute hemorrhagic stroke, not having any collagen tissue diseases, any previous surgical operations, angiography, myocardial infarction, angina pectoris and history of trauma in the last three months and not having any infectious findings and any known malignity. Similar conditions apart from the stroke were applied to the controls as well. Results: In the firsth 5th and 10th days serum C<inf>3</inf>, C<inf>4</inf>, IgA, IgG, IgM and fibrinogen levels of the patients were measured, which were later evaluated in terms of their relations with clinical and CT findings. With regard to the average age, no difference was found between 87 acute hemorrhagic stroke patients (aver. Age 59.643 ± 10.611) and 46 controls (aver. Age 62.042± 6.596) (p=0.165). Serum C<inf>3</inf> levels of the patients measured in the first 5th day of the stroke were found significantly higher than the control group (1.341± 0.544 and 1.169± 0.171 respectively) (p=0.043). C<inf>4</inf> levels were found higher than the control group (0.387±0.223, 0.223±0.118 respectively) (p=0.000). Serum IgA and M levels and number of leukocytes were higher in the stroke group for the initial 5 days (p=0.016, 0.034, 0.000, respectively). However, we found out that fibrinogen levels raised distinctively in the 10th day (p=0.000). In those with lesion volumes > 30 cm³ on the CT, C<inf>3</inf> levels have no statistical importance but they were found high (p=0.073). A positive correlation was established between C<inf>3</inf> levels and the lesion volume (p=0.041). C<inf>3</inf> levels measured on the 10th day in the patients who died, were found higher than those of alive (p= 0.045). Conclusion: As a result, we think that the complement system is affected in hemorrhagic stroke and this is particularly in hyperacute period and that complement components have relations with the immunologic and clinical parameters.