Relationship between Excitatory Amino Acid Release and Outcome after Severe Human Head Injury

S. S. Koura, E. M.R. Doppenberg, Anthony Marmarou, S. Choi, H. F. Young, R. Bullock

Research output: Contribution to journalArticle

108 Scopus citations

Abstract

In previous studies, Katayama and our group have documented a massive increase in excitatory amino acid release following traumatic brain injury, in both rat fluid percussion, and humans [2,5]. To test the hypothesis that the magnitude of this "Excitotoxic Surge" plays a significant role in determining 6-month patient outcome. We have studied 83 consecutive severely head injured patients at the Medical College of Virginia for inclusion into this study. A microdialysis probe was placed within the cortex to continuously measure dialysate excitatory amino acids (Glutamate and Aspartate), along with several other analytes for approximately 5 days after injury. ICP, CPP, and MABP measurements were also time linked with each analyte measurement to create a neurochemical, clinical, and physiological "prolile" for each patient. Outcome was determined by follow up using the Glasgow 6-Month outcome scale. A very strong correlation existed between the release of the EAA's glutamate and aspartate after TBI (p < 0.0001). Patients with significantly elevated mean glutamate values for the entire monitoring period were most likely to exhibit elevated levels of ICP. The magnitude of glutamate released significantly correlates with 6-month patient outcome (p = 0.0234). When patients were subdivided by the CT diagnosis of lesion type, we found that those patients with contusions displayed the highest overall of EAA's.

Original languageEnglish (US)
Pages (from-to)244-246
Number of pages3
JournalActa Neurochirurgica, Supplement
Volume1998
Issue numberSUPPL. 71
DOIs
StatePublished - Jan 1 1998

Keywords

  • Excitatory amino acid
  • Head injury
  • Outcome

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Neurology

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    Koura, S. S., Doppenberg, E. M. R., Marmarou, A., Choi, S., Young, H. F., & Bullock, R. (1998). Relationship between Excitatory Amino Acid Release and Outcome after Severe Human Head Injury. Acta Neurochirurgica, Supplement, 1998(SUPPL. 71), 244-246. https://doi.org/10.1007/978-3-7091-6475-4_70