1. [Cerebral microdialysis in stroke].
- Author
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Berger C, Dohmen C, Maurer MH, Graf R, and Schwab S
- Subjects
- Brain Edema physiopathology, Diagnostic Imaging, Electrolytes cerebrospinal fluid, Glutamic Acid cerebrospinal fluid, Glycerol cerebrospinal fluid, Humans, Hypothermia, Induced, Infarction, Middle Cerebral Artery physiopathology, Infarction, Middle Cerebral Artery therapy, Lactic Acid cerebrospinal fluid, Neurologic Examination, Oximetry instrumentation, Predictive Value of Tests, Prognosis, Pseudotumor Cerebri physiopathology, Pyruvic Acid cerebrospinal fluid, Reference Values, Water-Electrolyte Balance physiology, Brain Edema diagnosis, Critical Care, Energy Metabolism physiology, Infarction, Middle Cerebral Artery diagnosis, Microdialysis instrumentation, Monitoring, Physiologic instrumentation, Nerve Tissue Proteins cerebrospinal fluid, Neurotransmitter Agents cerebrospinal fluid, Oxygen Consumption physiology, Pseudotumor Cerebri diagnosis
- Abstract
Cerebral microdialysis is an invasive technique for neurochemical monitoring that has been established for neuro-critical disorders such as subarachnoid hemorrhage and severe brain injury. We present data on cerebral microdialysis in stroke patients which were obtained in an ongoing study supported by the German Ministry for Education and Research. So far, 50 patients have been included who required critical care due to massive stroke of the middle cerebral artery territory. By correlating the microdialysis results with follow-up CT scans, we could define the neurochemical characteristics of three different brain compartments: (1) noninfarcted brain tissue with normal microdialysis values, (2) brain areas adjacent to the infarct core which were not hypodense in CT scans but caused reversible neurochemical alterations, and (3) the infarct core with massive concentration changes which did not normalize over the measuring period of 3 to 5 days. Microdialysis values averaged over time and correlated with initial PET scans helped to describe neurochemical predictors of a malignant, i.e., life-threatening, space-occupying course of the ischemic stroke. We discuss the value of this method in guiding therapy and predicting clinical outcome in the context of other neurological critical care disorders and describe the pros and cons of cerebral microdialysis as an invasive monitoring technique.
- Published
- 2004
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