Big-endothelin in acute ischemic stroke.

Plasma big-endothelin (BE) in 12 patients with acute severe ischemic stroke was studied. Six patients developed complete supratentorial infarctions, and six patients had severe infarctions of pons, cerebellum, and/or medulla. Significant elevations of BE during the first 2 weeks after the initial stroke and significant differences between the pathophysiological subgroups of stroke did not occur. Only patients with a poor outcome showed significant elevations of BE in contrast to patients with a better prognosis (p ≤ 0.05). Patients with supratentorial infarctions demonstrated a tendency of higher BE levels than patients with infratentori-al stroke (p ≤ 0.07). These results support the theory that endothelins represent the amount of damaged cerebral tissue rather than the endothelium leakage. Low endothelin concentrations may play a role in local vasodilation and reperfusion.