Document Detail

Association between intracranial pulse pressure levels and brain energy metabolism in a patient with an aneurysmal subarachnoid haemorrhage.
MedLine Citation:
PMID:  17714572     Owner:  NLM     Status:  MEDLINE    
This report addresses whether intracranial pulse pressure amplitudes are associated with brain energy metabolism, examined by intracerebral microdialysis. We present a 65-year-old female with an aneurysmal subarachnoid haemorrhage (SAH) from a left posterior communicating artery (PCOM) aneurysm. She underwent simultaneous intracranial pressure (ICP) monitoring and microdialysis (MD) as part of a diagnostic workout because of a lack of clinical improvement after long-term intensive care management. Over a 4-day period, a total of 128 samples of metabolites (glutamate, glycerol, lactate and pyruvate) were gathered, allowing retrospective comparisons with the levels of intracranial pulse pressure amplitudes (the mean ICP wave amplitude). During this 4-day period, mean ICP was normal (<15 mmHg), while mean ICP wave amplitude was high (>/=5 mmHg) in 47% of the recording time. There was a highly significant relationship between the levels of the mean ICP wave amplitude and the levels of glutamate, glycerol and lactate/pyruvate ratio. The levels of metabolites were increased when the mean ICP wave amplitude was >/=5 mmHg as compared with mean ICP wave amplitude levels <5 mmHg. We tentatively suggest that increased mean ICP wave amplitudes indicative of reduced intracranial compliance can be associated with brain ischaemia.
P K Eide; G Bentsen; M Stanisic; A Stubhaug
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-08-20
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  51     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-13     Completed Date:  2008-01-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1273-6     Citation Subset:  IM    
Department of Neurosurgery, Rikshospitalet-Radiumhospitalet University Hospital, Oslo, Norway.
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MeSH Terms
Brain / metabolism*
Brain Ischemia / blood,  diagnosis*
Glutamic Acid / blood
Glycerol / blood
Intracranial Aneurysm / metabolism*,  physiopathology
Intracranial Pressure / physiology*
Lactic Acid / blood
Microdialysis / methods
Pyruvic Acid / blood
Subarachnoid Hemorrhage / metabolism*,  physiopathology
Reg. No./Substance:
127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 56-81-5/Glycerol; 56-86-0/Glutamic Acid

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