Abstract
Intracerebral MD enables the retrieval of endogenous substances from the extracellular fluid (ECF) of the brain and has been demonstrated to be a sensitive technique for early detection of subtle vasospasm-induced neurometabolic abnormalities in patients with subarachnoid hemorrhage (SAH). The aim of this study was to monitor cortical extracellular concentrations of energy metabolism markers, such as glucose and lactate, neurotransmitter amino acids, such as glutamate, aspartate, GABA and taurine to identify any neurochemical patterns of cerebral ischemia. A prospective clinical study was conducted on a group of 16 patients with non-severe SAH operated on within 72 hours after initial bleeding. Following aneurysm clipping, an MD catheter was inserted in the cortical region where vasospasm could be expected to develop, and perfused with artificial CSF at 0.3 µl/min flow rate. Dialysate was collected every 6 hours and then analyzed on High Performance Liquid Cromatography (HPLC) for glucose, lactate, pyruvate, glutamate, aspartate, GABA and taurine. Mean ECF taurine concentrations ranged from 1.4 ± 0.7 to 12.3 ±7.8 µmol/l in single patients: global mean value was 5.8 ± 3.8 µmol/l. In this series, the highest absolute taurine value was 25.7 µmol/l, observed in a patient who developed clinical and radiological signs of cerebral ischemia.Nine patients presented clinical disturbances related to cerebral vasospasm. In this setting, representing a mild-to-moderate hypoxic condition, MD data demonstrated that lactate is the most sensitive marker of cellular energy imbalance. Increased lactate levels positively correlated with glutamate (P<0.0001), aspartate (P<0.0001), GABA (P<0.0001) and taurine (P<0.0001) concentrations. These results suggest that also in humans increased taurine levels reflect a condition of cellular stress. This study confirms that MD is a sensitive technique to reveal subtle metabolic abnormalities possibly resulting in cell damage.
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References
Bianchi L, Della Corte L, Tipton KF (1999) Simultaneous determination of basal and evoked output levels of aspartate, glutamate, taurine and 4-aminobutyric acid during microdialysis and from superfused brain slices. J. Chromatogr. B 723:47–59.
Choi, D.W., 1988, Glutamate neurotoxicity and diseases of the nervous system. Neuron 1:623–634.
Hunt, W.E., Hess, R.M., 1968, Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 28: 14–19.
Jennet, B., Bond, M., 1975, Assessment of outcome after severe brain damage. A practical scale. Lancer 1:480–484.
Kassell, N.F., Sasaki, T., Colohan, A.RT., et al., 1985, Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke 16:562–572.
Kassel, N.F., Torner, J.C., Haley, E.C., Jr., et al., 1990, The international cooperative study on the timing of aneurysm surgery Part 1: Overall management results. J Neurosurg. 73: 18–36.
Kassel, N.F., Torner, J.C., Jane, J.A., et al., 1990, The international cooperative study on the timing of aneurysm surgery. Part 2: Surgical results. J Neurosurg. 73:37–47.
Lindegaard, K.F., Nornes, H., Bakke, S.J., et al., Cerebral vasospasm diagnosis by means of angiography and blood velocity measurements. Acta Neurochir. 100: 12–24.
Persson, L., Hillered, L., 1992, Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis. J Neurosurg. 76:72–80.
Persson, L., Valtysson, J., Enblad, P., et al., 1996, Neurochemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage. J Neurosurg. 84:606–616.
Saveland, H., Hillman, J., Brandt, L., et al., 1992, Overall outcome in aneurysmal subarachnoid hemorrhage: a prospective study from neurosurgical units in Sweden during a 1-year period. JNeurosurg. 76:729–734.
Saveland, H., Nilsson, O., Boris-Moller, F., et al., 1996, Intracerebral microdialysis of glutamate and aspartate in two vascular territories after aneurysmal subarachnoid hemorrhage. Neurosurgery 38: 12–20.
Seiler, R.W., Grolimund, P., Aaslid, R, et al., 1986, Cerebral vasospasm evaluated by transcranial ultrasound correlated with clinical grade and CT-visualized subarachnoid hemorrhage.JNeurosurg. 64:594–600.
Sloan, M.A., Haley, E.C. Jr, Kassel, N.F., et al., 1989, Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage. Neurology 39: 1514–1518.
Teasdale, G., hill-Jones, R.P., Lindsay, K.W., 1983, Clinical assessment of SAH. J. Neurosurg. 59: 550–555
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© 2002 Kluwer Academic Publishers
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De Micheli, E. et al. (2002). Post-Operative Monitoring of Contical Taurine in Patients with Subarachnoid Hemorrhage: A Microdialysis Study. In: Della Corte, L., Huxtable, R.J., Sgaragli, G., Tipton, K.F. (eds) Taurine 4. Advances in Experimental Medicine and Biology, vol 483. Springer, Boston, MA. https://doi.org/10.1007/0-306-46838-7_64
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DOI: https://doi.org/10.1007/0-306-46838-7_64
Publisher Name: Springer, Boston, MA
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