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Clinical Biochemistry
Volume 38, Issue 1, January 2005, Pages 97-100
 
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doi:10.1016/j.clinbiochem.2004.09.013    How to Cite or Link Using DOI (Opens New Window)
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

Luciano Cristoforia, Barbara Tavazzib, Roberta Gambina, Roberto Vagnozzic, Stefano Signorettid, Angela M. Amorinie, Giovanna Fazzinae and Giuseppe Lazzarinoe, Corresponding Author Contact Information, E-mail The Corresponding Author

aDepartment of Neurosurgery, University Hospital of Verona, Italy bInstitute of Biochemistry and Clinical Biochemistry, Catholic University of Rome, Italy cDepartment of Neurosciences, Chair of Neurosurgery, University of Rome “Tor Vergata,” Italy dDepartment of Neurosciences, Division of Neurosurgery, “San Camillo” Hospital, Rome, Italy eDepartment of Chemical Sciences, Laboratory of Biochemistry, University of Catania, Italy

Received 24 June 2004; 
revised 2 September 2004; 
accepted 20 September 2004. 
Available online 17 November 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

Article Outline

Introduction
Methods
Sampling and analysis of CSF
Results
Discussion
Acknowledgements
References


Clinical Biochemistry
Volume 38, Issue 1, January 2005, Pages 97-100
 
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