Abstract
Ten severely head injured patients (GCS≤8), aged 17–62 years, were studied in order to investigate the role of lipoperoxidation in secondary brain damage. No patients had intracranial mass lesions, shock, hypoxemia, fever or sepsis. Blood samples were taken from the jugular bulb and from the right atrium, and thiobarbituric acid reacting substances (TBARS) were measured in plasma by spectrophotometry. Arterio-jugular venous oxygen differences (AVDO2) were obtained in seven patients, in order to estimate cerebral blood flow. Jugular TBARS (TBARSj) were always elevated (from To, to 2 h after injury) and correlated in a linear fashion with TBARS of right atrium (TBARSv):r=0.74,p<0.001. TBARSj and AVDO2 are closely correlated, in accordance with an exponential function (R=0.45,p<0.001) which describes how any cerebral perfusion derangement determines high levels of TBARSj, confirming lipoperoxidation as a key factor in the final common pathway of secondary posttraumatic brain damage.
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References
Demopoulos HB, Milvy P, Kakari S, Ransohof J (1972) Molecular aspect of membrane structure in cerebral edema. In: Reulen JH, Schuermann K (eds) Steroids and brain edema. Springer, Vienna, pp 29–39
Milvy P, Kakari S, Campbell JB, Demopoulos HB (1973) Paramagnetic species and radical products in cat spinal cord. Ann NY Acad Sci 222:1102–1111
Gennarelli TA (1987) Cerebral concussion and diffuse brain injuries. In: Cooper PR (ed) Head injury. Williams and Wilkins, Baltimore, pp 108–124
Beuge JA, Aust SD (1978) Microsomal lipid peroxydation. In: Fleisher S, Packer L (eds) Methods in enzymology: biomembranes, vol 52, Part C. Academic Press, New York, pp 302–310
Obrist WD, Langfitt TW, Jaggi JL, Cruz J, Gennarelli TA (1984) Cerebral blood flow and metabolism in comatose patients with acute head injury. J Neurosurg 61:241–253
Miller JD (1985) Head injury and brain ischemia. Implications for therapy. Br J Anaesth 57:120–129
Means ED, Anderson DK (1987) Pathophysiology of acute spinal cord injury. In: Davidoff RA (ed) Handbook of the spinal cord, vol 4. Dekker, New York, pp 19–61
Young W (1985) Blood flow, metabolic and neurophysiological mechanisms in spinal cord injury. In: Becker DB, Povlishock JR (eds) Central nervous system trauma status report. NIH, Bethesda, pp 463–474
Hall ED, Wolf DL (1987) Post-traumatic spinal cord ischemia: relationships to injury severity and physiological parameters. CNS Trauma 4:15–25
Hall ED, Braughler JM (1981) Acute effects of intravenous glucocorticoid pretreatment on the in vitro peroxydation of cat spinal cord tissue. Exp Neurol, 73:321–324
Halliwell B, Gutteridge JMC (1984) Lipid peroxydation, oxygen radicals, cell damage and antioxidant therapy. Lancet I:1396–1397
Kosugi H, Kikugawa K (1989) Potential thiobarbituric acid reactive substances in peroxidized lipids. Free Radical Biol Med 7:205–207
Bochicchio M, Zappa S, Calovini D, Latronico N, Pontoglio GL, Mariotti M, Amicucci G, Candiani A (1988) The role of oxygen free radicals in the pathogenesis of traumatic brain damage in humans. Preliminary report (Abstract). Intensive Care Med [Suppl] 14:331
Kurihara M (1985) Role of monoamines in experimental spinal cord injury in rats: relationship between Na−K ATPase and lipid peroxydation. J Neurosurg 62:743–749
Hall ED, Braughler JM (1987) The role of oxygen radical-induced lipid peroxydation in acute central nervous system trauma. In: Halliwell B (ed) Oxygen radicals and tissue injury. Upjohn Company Kalamazoo, pp 92–98
Robertson CS, Narayan RN, Gokaslan ZL, Pahwa R, Grossman RG, Caram PJ, Allen E (1989) Cerebral arteriovenous oxygen difference as an estimate of cerebral blood flow in comatose patients. J Neurosurg 70:222–230
Kety SS, Schmidt CF (1948) The nitrous oxide method for the quantitative determination of cerebral blood flow in man: theory, procedure and normal values. J Clin Invest 27:476–483
Young W, Flamm ES (1982) Effect of high-dose corticosteroid therapy on blood flow, evoked potentials, and extracellular calcium in experimental spinal injury. J Neurosurg 57:667–673
Hall ED, Wolf DL, Braughler JM (1984) Effect of a single large dose of methylprednisolone sodium succinate on experimental post-traumatic spinal cord ischemia: dose-response and time-action analysis. J Neurosurg 61:124–130
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Bochicchio, M., Latronico, N., Zani, D.G. et al. Free radical-induced lipoperoxidation and severe head injury. Intensive Care Med 16, 444–447 (1990). https://doi.org/10.1007/BF01711223
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DOI: https://doi.org/10.1007/BF01711223