Biochemical analysis of the cerebrospinal fluid: evidence for catastrophic energy failure and oxidative damage preceding brain death in severe head injury: a case report

To compare biochemical and clinical parameters in a case of fatal severe traumatic brain injury (TBI) with secondary insult. A TBI patient was catheterized for intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) analysis of ascorbate, malondialdehyde, oxypurines, and nucleosides. Ox...

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Bibliographic Details
Published in:Clinical biochemistry 2005, Vol.38 (1), p.97-100
Main Authors: Cristofori, Luciano, Tavazzi, Barbara, Gambin, Roberta, Vagnozzi, Roberto, Signoretti, Stefano, Amorini, Angela M., Fazzina, Giovanna, Lazzarino, Giuseppe
Format: Article
Language:English
Subjects:
Ascorbic Acid - cerebrospinal fluid
Brain Death - cerebrospinal fluid
Brain Injuries - cerebrospinal fluid
Cerebrospinal fluid
Energy metabolism
High-performance liquid chromatography
Humans
Male
Malondialdehyde - cerebrospinal fluid
Middle Aged
Nucleosides - cerebrospinal fluid
Oxidative Stress
Purines - cerebrospinal fluid
Time Factors
Traumatic brain injury
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Summary:To compare biochemical and clinical parameters in a case of fatal severe traumatic brain injury (TBI) with secondary insult. A TBI patient was catheterized for intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) analysis of ascorbate, malondialdehyde, oxypurines, and nucleosides. Oxidative brain damage preceded ATP catabolite increment in the CSF even with ICP below 20 mm Hg. Sustained oxidative stress caused irreversible energy state derangement followed by a refractory ICP rise. Massive oxypurine and nucleoside release was recorded 36 h before brain death. Molecular events, detected by biochemical CSF analysis and preceding modification of clinical parameters in severe TBI with secondary insult, are discussed.
ISSN:0009-9120
1873-2933
DOI:10.1016/j.clinbiochem.2004.09.013