| Brain energy metabolism in patients with spontaneous subarachnoid hemorrhage and global cerebral edema. | |
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MedLine Citation:
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PMID: 20495425 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Previous studies of spontaneous subarachnoid hemorrhage (SAH) have shown that global cerebral edema on the first computed tomography scan is associated with a more severe initial injury and is an independent predictor of poor outcome. Effects of secondary ischemic events also influence outcome after SAH. OBJECTIVE: This study demonstrates that early global edema is related to markers of an increased cerebral energy metabolism as measured with intracerebral microdialysis, which could increase vulnerability to adverse events. METHODS: Fifty-two patients with microdialysis monitoring after spontaneous SAH were stratified according to the occurrence of global cerebral edema on the first computed tomography scan taken a median of 2 hours after the initial bleed. Microdialysis levels of glucose, lactate, and pyruvate were compared between the global edema (n = 31) and no global edema (n = 21) groups. Clinical outcome was assessed with the Glasgow Outcome Scale score at >/= 6 months. RESULTS: Patients with global edema showed significantly elevated lactate and pyruvate levels 70 to 79 hours after SAH and marginally significantly higher levels of lactate 60 to 69 hours and 80 to 89 hours after SAH. There was a trend toward worse outcome in the edema group. CONCLUSION: Patients with global cerebral edema have higher interstitial levels of lactate and pyruvate. The edema group may have developed a cerebral hypermetabolism to meet the increased energy demand in the recovery phase after SAH. This stress would make the brain more vulnerable to secondary insults, increasing the likelihood of energy failure. |
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Authors:
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Maria Zetterling; Lena Hallberg; Lars Hillered; Torbjörn Karlsson; Per Enblad; Elisabeth Ronne Engström |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurosurgery Volume: 66 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-24 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 1102-10 Citation Subset: IM |
Affiliation:
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Department of Neuroscience, Neurosurgery, Uppsala University Hospital, Uppsala, Sweden. maria.zetterling@telia.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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metabolism Brain / blood supply, metabolism* Brain Chemistry / physiology Brain Edema / diagnosis*, etiology, metabolism* Energy Metabolism / physiology* Extracellular Fluid / metabolism Glucose / metabolism Humans Lactic Acid / metabolism Microdialysis Oxidative Phosphorylation Predictive Value of Tests Pyruvic Acid / metabolism Subarachnoid Hemorrhage / complications*, diagnosis, metabolism* Tomography, X-Ray Computed Up-Regulation / physiology |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 50-99-7/Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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