Document Detail

Bedside biochemical monitoring of the penumbra zone surrounding an evacuated acute subdural haematoma.
MedLine Citation:
PMID:  12911466     Owner:  NLM     Status:  MEDLINE    
We describe a penumbra zone with increased biochemical vulnerability in cerebral cortex underlying an evacuated acute subdural haematoma. Two microdialysis catheters were placed in this zone and one catheter was placed in the opposite, less injured hemisphere. The microdialysis perfusates were analysed bedside for glucose, pyruvate, lactate, glutamate, and glycerol. In the penumbra zone, but not in the opposite hemisphere, energy metabolism was seriously disturbed with signs of cell membrane degradation. During an adverse event (decrease in haemoglobin level, systemic blood pressure and cerebral perfusion pressure) the perturbation of energy metabolism increased in this zone. Energy metabolism recovered and the signs of cell membrane degradation disappeared after normalization of the physiological parameters. We use the term biochemical penumbra zone to describe an area with signs of energy failure and cell membrane degradation, which has a capacity to regain a normal metabolic pattern but also an increased vulnerability to secondary insults.
N Ståhl; W Schalén; U Ungerstedt; C-H Nordström
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta neurologica Scandinavica     Volume:  108     ISSN:  0001-6314     ISO Abbreviation:  Acta Neurol. Scand.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-12     Completed Date:  2003-10-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370336     Medline TA:  Acta Neurol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  211-5     Citation Subset:  IM    
Department of Clinical Neuroscience, Lund University Hospital, Lund, Sweden.
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MeSH Terms
Cerebral Cortex / metabolism*
Glucose / metabolism
Glutamic Acid / metabolism
Glycerol / metabolism
Hematoma, Subdural, Acute / metabolism*,  radiography,  surgery*
Lactic Acid / metabolism
Middle Aged
Pyruvic Acid / metabolism
Time Factors
Tomography, X-Ray Computed
Reg. No./Substance:
127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 50-99-7/Glucose; 56-81-5/Glycerol; 56-86-0/Glutamic Acid

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