Summary
In previous studies, Katayama and our group have documented a massive increase in excitatory amino acid release following traumatic brain injury, in both rat fluid percussion, and humans [2,5]. To test the hypothesis that the magnitude of this “Excitotoxic Surge” plays a significant role in determining 6-month patient outcome. We have studied 83 consecutive severely head injured patients at the Medical College of Virginia for inclusion into this study. A microdialysis probe was placed within the cortex to continuously measure dialysate excitatory amino acids (Glutamate and Aspartate), along with several other analytes for approximately 5 days after injury. ICP, CPP, and MABP measurements were also time linked with each analyte measurement to create a neurochemical, clinical, and physiological “profile” for each patient. Outcome was determined by follow up using the Glasgow 6-Month outcome scale. A very strong correlation existed between the release of the EAA’s glutamate and aspartate after TBI (p < 0.0001). Patients with significantly elevated mean glutamate values for the entire monitoring period were most likely to exhibit elevated levels of ICP. The magnitude of glutamate released significantly correlates with 6-month patient outcome (p = 0.0234). When patients were subdivided by the CT diagnosis of lesion type, we found that those patients with contusions displayed the highest overall of EAA’s.
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© 1998 Springer-Verlag Wien
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Koura, S.S., Doppenberg, E.M.R., Marmarou, A., Choi, S., Young, H.F., Bullock, R. (1998). Relationship between Excitatory Amino Acid Release and Outcome after Severe Human Head Injury. In: Marmarou, A., et al. Intracranial Pressure and Neuromonitoring in Brain Injury. Acta Neurochirurgica Supplements, vol 71. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6475-4_70
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DOI: https://doi.org/10.1007/978-3-7091-6475-4_70
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