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Glutamic oxalacetic and glutamic pyruvic transaminase levels in CSF and blood were estimated in 25 normal individuals and 50 patients with varying grades of head injury. CSF GOT, and to a lesser extent GPT, showed significant elevation proportionate to the degree of brain injury. Serum GOT was raised in more severe injuries. CSF GOT and GPT levels showed a significant correlation with the prognosis of the case.

Lactic acid levels were estimated in cerebrospinal fluid and blood of 25 normal individuals and 50 patients with varying grades of head injury. CSF lactic acid levels showed significant elevation proportionate to the degree of brain injury. Elevation of blood lactic acid was less pronounced. CSF lactic acid levels closely correlated with the prognosis of the case, and an increase above 50 mgm% was not compatible with life.

Acid-base parameters and oxygen tension were studied in arterial blood and lumbar CSF of 45 subjects in three groups of controls, head injuries, and postoperative cases. CSF in both groups of head injury and postoperative cases showed changes of metabolic acidosis with the arterial blood changes of respiratory alkalosis. Both groups had significant hypoxaemia. CSF acidosis is an indication of cerebral metabolic disturbance. It is proportional to the severity of brain damage, and permits a prognosis for further clinical progress. It is recommended that patients with severe brain lesions should be put on controlled ventilation to relieve them of respiratory overwork and to combat cerebral oedema.