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Case Reports
. 2005 Jan;38(1):97-100.
doi: 10.1016/j.clinbiochem.2004.09.013.

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 Cristofori  1 , Barbara Tavazzi, Roberta Gambin, Roberto Vagnozzi, Stefano Signoretti, Angela M Amorini, Giovanna Fazzina, Giuseppe Lazzarino
Affiliations
Case Reports

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 Cristofori et al. Clin Biochem. 2005 Jan.

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.

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