Child's Nervous System

, Volume 7, Issue 3, pp 135–138 | Cite as

The prognostic value of the brain sodium-potassium ATPase enzyme concentration in head injury

  • Z. Seddik
  • Y. A. Habib
  • E. El Shamy
Original Papers


Sodium-potassium adenosine triphosphatase (ATPase) enzyme was determined in the brain tissue of 11 patients with head injury and 6 control patients. Patients with head injury included in this study were selected from two categories: (a) patients in deep coma due to severe head injury [Glasgow Coma Scale (GCS)<8; 6 cases]; (b) patients with depressed skull fractures with dural tears who were conscious and able to give an adequate verbal response (GCS>10; 5 cases). The level of the enzyme was significantly reduced in comatose patients with severe head injury as compared to the controls (P<0.001) or to conscious patients with depressed fractures (P<0.001). In the group of conscious patients with depressed fractures, the enzyme level was no different from that of the controls (P = 0.4215). All comatose patients with severely reduced enzyme levels subsequently died, whereas those with depressed fractures with normal enzyme levels survived. The relationship between a low enzyme level and brain edema in severe head injury is discussed.

Key words

Head injury ATPase Diphenylhydantoin Coma Cerebral edema 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bader H, Post RL, Bond GH (1968) Comparison of sources of a phosphorylated intermediate in transport ATPase. Biochem Biophys Acta 150:41–46Google Scholar
  2. 2.
    Broodle WD, Nelson SR (1968) The effect of diphenylhydantoin on energy reserve levels in brain. Fed Proc 27:751Google Scholar
  3. 3.
    Bruce DA, Langfitt TW, Miller D, Schultz H, Vapalahti MP, Stanek A, Goldbery HI (1973) Regional cerebral blood flow, intracranial pressure and brain metabolism in comatose patients. J Neurosurg 38:131–144Google Scholar
  4. 4.
    Crane P, Swanson PD (1970) Diphenylhydantoin and the cations and phosphates of electrically stimulated brain slices. Neurology 20:1119–1123Google Scholar
  5. 5.
    Fiske CH, Subbarow Y (1925) The colorimetric determination of phosphorus. J Biol Chem 66:375–400Google Scholar
  6. 6.
    Jennett B, Teasdale G (1981) Management of head injuries. Davis, PhiladelphiaGoogle Scholar
  7. 7.
    Katz AI, Epstein FH (1967) The role of sodium-potassium activated adenosine triphosphatase in the reabsorption of sodium by the kidney. J Clin Invest 46:1999–2011Google Scholar
  8. 8.
    Klatzo I (1976) Presidential address: neuropathological aspects of brain edema. J Neuropathol Exp Neurol 26:1–14Google Scholar
  9. 9.
    Kogure K, Scheinberg P, Kishikawa H, Busto R (1976) The role of monoamines and cyclic AMP in ischaemic brain edema. In: Pappius HM, Feindel W (eds) Dynamics of brain edema. Springer, Berlin Heidelberg New York, pp 203–214Google Scholar
  10. 10.
    Kukovetz WR, Roch G (1972) The positive inotropic effect of cyclic AMP. In: Greengard P, Paoletti R, Robinson GA (eds) Advances in cyclic nucleotide research, vol 1. Raven Press, New York, pp 261–290Google Scholar
  11. 11.
    Livingstone AS, Potvin M, Gotesky CA, Finlayson MH, Hinchley EJ (1977) Changes in the blood-brain barrier in hepatic coma after hepatectomy in the rat. Gastroenterology 73:697–704Google Scholar
  12. 12.
    Lowry OH, Rosebrough NJ, Farr AL, Randall RJ (1951) Protein measurement with folin phenol reagent. J Biol Chem 193:265Google Scholar
  13. 13.
    Nakao T, Tashima Y, Nagano K, Nakao M (1965) Highly specific sodium-potassium-activated adenosinc triphosphatase from various tissues of rabbits. Biochem Biophys Res Commun 19:755–758Google Scholar
  14. 14.
    O'Fallon JV, Brosemer RW, Harding JW (1981) The sodiumpotassium ATPase: a plausible trigger for voltage-independent release of cytoplasmic neurotransmitters. J Neurochem 26:369–378Google Scholar
  15. 15.
    Olesen J, Paulson OB, Lassen NA (1971) Regional cerebral blood flow in man determined by the initial slope of the clearance of intra-arterially injected133Xe. Stroke 2:519–540Google Scholar
  16. 16.
    Overgaard J, Tweed WA (1975) rcBF in impending brain death. Acta Neurochir (Wien) 31:167–175Google Scholar
  17. 17.
    Owen JS, Bruckdorfer KR, Day RC, McIntyre N (1982) Decreased erythrocyte membrane fluidity and altered lipid composition in human liver disease. J Lipid Res 23:124–133Google Scholar
  18. 18.
    Pincus JH, Grove I, Marino BB, Glaser GE (1970) Studies on the mechanism of action of diphenylhydantoin. Arch Neurol 22:566–571Google Scholar
  19. 19.
    Skou JC (1957) The influence of some cations on adenosine triphosphatase from peripheral nerves. Biochem Biophys Acta 23:394–401Google Scholar
  20. 20.
    Skou JC (1962) Preparation from brain and kidney of the enzyme system involved in active transport of sodium and potassium. Biochem Biophys Acta 58:314–325Google Scholar
  21. 21.
    Snedcor GW (1957) Statistical methods applied to experiments in agriculture and biology, 5th edn. The Iowa State College press, Ames, IowaGoogle Scholar
  22. 22.
    Sweadner KJ (1970) Two molecular forms of sodium, potassium stimulated ATPase in brain. J Biol Chem 254:6060–6067Google Scholar
  23. 23.
    Thomas TC (1972) Electrogenic sodium pump in nerve and muscle cells. Physiol Rev 52:563–594Google Scholar
  24. 24.
    Tweed WA, Overgaard J (1976) Brain edema after head injury. In: Pappius HM, Feindel W (eds) Dynamics of brain edema. Springer, Berlin Heidelberg New York, pp 323–325Google Scholar
  25. 25.
    Woodhall B, Kramer RS, Currie WD, Sanders AP (1971) Brain energetics and neurosurgery. J Neurosurg 34:3–14Google Scholar
  26. 26.
    Zaki AEO, Ede RJ, Davis M, Williams R (1984) Experimental studies of blood brain barrier permeability in acute hepatic failure. Hepatology 4:359–363Google Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • Z. Seddik
    • 1
  • Y. A. Habib
    • 2
  • E. El Shamy
    • 2
  1. 1.Department of Neurosurgery, Faculty of MedicineUniversity of AlexandriaAlexandriaEgypt
  2. 2.Department of Physiology, Faculty of MedicineUniversity of AlexandriaAlexandriaEgypt

Personalised recommendations