Determinants of cerebral extracellular potassium after severe human head injury

Egon M R Doppenberg, M. Reinert, A. Zauner, T. S. Massie, Ross Bullock

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The key role players of brain swelling seen after severe human head injury have only been partly determined. We used our human head injury data base to determine relationships between potassium, glutamate, lactate and cerebral blood flow (CBF). A total of 70 severely head injured patients (GCS ≤ 8) were studied using intracerebral microdialysis to measure extracellular glutamate, potassium and lactate. Xenon CT was used to determine regional cerebral blood flow (rCBF). The mean ± SEM of the r value of all patients, between potassium and glutamate, and potassium and lactate was 0.25 ± 0.04 (p < 0.0001) and 0.17 ± 0.06 (p = 0.006), respectively, demonstrating in both cases a positive relationship. rCBF was negatively correlated with potassium with marginal significance (r = 0.35, p = 0.08). When separated into two groups, patients with contusion had higher potassium levels than patients without contusion (1.55 ± 0.03 mmol/l versus 1.26 ± 0.02 mmol/l, respectively). These results in severely head injured patients confirm previous in vitro and animal studies in which relationships between potassium, glutamate, lactate and CBF were found. Potassium efflux is a major determinant of cell swelling leading to clinically significant cytotoxic edema due to increased glutamate release during reduced cerebral blood flow.

Original languageEnglish
Pages (from-to)31-34
Number of pages4
JournalActa Neurochirurgica, Supplement
Volume1999
Issue numberSUPPL. 75
StatePublished - Dec 1 1999
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Craniocerebral Trauma
determinants
Potassium
Glutamic Acid
potassium
Blood
glutamates
Lactic Acid
blood flow
lactates
Contusions
Regional Blood Flow
Swelling
Head
Xenon
swelling
Brain Edema
Microdialysis
Edema

Keywords

  • Cerebral blood flow
  • Glutamate
  • Lactate
  • Potassium
  • Severe human head injury

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Neurology

Cite this

Doppenberg, E. M. R., Reinert, M., Zauner, A., Massie, T. S., & Bullock, R. (1999). Determinants of cerebral extracellular potassium after severe human head injury. Acta Neurochirurgica, Supplement, 1999(SUPPL. 75), 31-34.

Determinants of cerebral extracellular potassium after severe human head injury. / Doppenberg, Egon M R; Reinert, M.; Zauner, A.; Massie, T. S.; Bullock, Ross.

In: Acta Neurochirurgica, Supplement, Vol. 1999, No. SUPPL. 75, 01.12.1999, p. 31-34.

Research output: Contribution to journalArticle

Doppenberg, EMR, Reinert, M, Zauner, A, Massie, TS & Bullock, R 1999, 'Determinants of cerebral extracellular potassium after severe human head injury', Acta Neurochirurgica, Supplement, vol. 1999, no. SUPPL. 75, pp. 31-34.
Doppenberg EMR, Reinert M, Zauner A, Massie TS, Bullock R. Determinants of cerebral extracellular potassium after severe human head injury. Acta Neurochirurgica, Supplement. 1999 Dec 1;1999(SUPPL. 75):31-34.
Doppenberg, Egon M R ; Reinert, M. ; Zauner, A. ; Massie, T. S. ; Bullock, Ross. / Determinants of cerebral extracellular potassium after severe human head injury. In: Acta Neurochirurgica, Supplement. 1999 ; Vol. 1999, No. SUPPL. 75. pp. 31-34.
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