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CC-BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2017; 06(02): 086-094
DOI: 10.1055/s-0037-1606310
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury

Deepak Kumar Gupta
1   Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
,
Anna Teresa Mazzeo
2   Department of Surgical Sciences, University of Torino, Torino, Italy
› Institutsangaben
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Publikationsverlauf

18. Juni 2017

19. Juli 2017

Publikationsdatum:
29. August 2017 (online)

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Abstract

Patients with traumatic brain injury (TBI) have variable outcomes subject to intracranial hypertension, ischemia, hypotension, and various biochemical alterations. Multimodality neurointensive monitoring is standard of care for decision making in all severe TBI cases at present in most neurotrauma units. Neuromonitoring tools, such as cerebral microdialysis, may contribute to understanding the pathomechanisms of acute brain injury, provide an early warning of secondary cerebral deterioration (therapeutic window of opportunity), and help in selecting the patients most suitable to benefit from this very invasive surgical rescue therapy. Cerebral microdialysis can be used as a measure of the effect of decompressive craniectomy on neurochemistry derangement and brain energy crisis jeopardizing the injured brain. Present review discusses the cerebral microdialysis, its usefulness, and role in prognostication of severe TBIs, especially in patients post-decompressive craniectomy. The authors also discuss the current consensus guidelines on usage of cerebral microdialysis in TBI patients.

Keywords

cerebral microdialysis - severe traumatic brain injury - decompressive craniectomy - ischemia - mitochondrial dysfunction
 

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