Copyright © 2004 The Canadian Society of Clinical Chemists Published by Elsevier Inc.
Biochemical analysis of the cerebrospinal fluid: evidence for catastrophic energy failure and oxidative damage preceding brain death in severe head injury: a case report
Received 24 June 2004;
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Abstract
Objectives:
To compare biochemical and clinical parameters in a case of fatal severe traumatic brain injury (TBI) with secondary insult.
Design and methods:
A TBI patient was catheterized for intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) analysis of ascorbate, malondialdehyde, oxypurines, and nucleosides.
Results:
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.
Conclusions:
Molecular events, detected by biochemical CSF analysis and preceding modification of clinical parameters in severe TBI with secondary insult, are discussed.
Keywords: Cerebrospinal fluid; Energy metabolism; High-performance liquid chromatography; Oxidative stress; Traumatic brain injury






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