Fibrinogen Concentration and Immunoelectrophoresis in the Internal Jugular Vein and the Corresponding Arterial Blood in Ischemic Brain Afflictions

Abstract

In plasma specimens simultaneously obtained from the bulb of the internal jugular vein (UV) and the brachial artery, fibrinogen, alpha- 1 antitrypsin and alpha- 2 macroglobulin concentrations were determined using the radial immunodiffusion technique. In 16 (22%) from the total 71 patients with various ischemic central nervous system afflictions studied, significant arteriovenous differences in the fibrinogen concentration were observed. In 32 patients from this series, simultaneous internal jugular vein and arterial plasma fibrinogen immunoelectrophoresis was performed. In 16 (50%) of these patients, immunoelectrophoretic abnormalities in the internal jugular vein plasma fibrinogen precipitate were established. In 12 (37%) instances, the internal jugular vein immunoelectropherograms revealed abnormal precipitates. From these 12 patients, ten (83%) showed immunoelectrophoretic abnormalities in the fibrinogen precipitation arc and in seven (58%) instances significant arteriovenous differences in the fibrinogen concentration were established. In the patients with abnormal precipitates in the internal jugular vein plasma immunoelectropherograms, the average interval of 13 days from the onset of neurological symptoms of the ischemic central nervous system affliction to the cannulation of the internal jugular vein was significantly shorter (P < 0.001) as compared to the average of 34 days in the patients with normal internal jugular vein immunoelectropherograms. The examination of UV plasma specimens by means of the techniques used appears to be prospectively important in two major areas: (1) as an auxiliary examination indicating localized thrombotic process in the vascular bed, primarily supplying the central nervous system; and on periodical examination, (2) as a laboratory indicator of resolution of the thrombosis.