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

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 u...

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Main Authors: Deepak Kumar Gupta, Anna Teresa Mazzeo
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2017-08-01
Series:Indian Journal of Neurosurgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606310
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author Deepak Kumar Gupta
Anna Teresa Mazzeo
author_facet Deepak Kumar Gupta
Anna Teresa Mazzeo
author_sort Deepak Kumar Gupta
collection DOAJ
description 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.
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spelling doaj-art-2f2317af70c745faab14c83d68bb358d2025-08-20T02:01:53ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672017-08-01060208609410.1055/s-0037-1606310Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain InjuryDeepak Kumar Gupta0Anna Teresa Mazzeo1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Surgical Sciences, University of Torino, Torino, ItalyPatients 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.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606310cerebral microdialysissevere traumatic brain injurydecompressive craniectomyischemiamitochondrial dysfunction
spellingShingle Deepak Kumar Gupta
Anna Teresa Mazzeo
Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury
Indian Journal of Neurosurgery
cerebral microdialysis
severe traumatic brain injury
decompressive craniectomy
ischemia
mitochondrial dysfunction
title Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury
title_full Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury
title_fullStr Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury
title_full_unstemmed Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury
title_short Cerebral Microdialysis: Going Deep into Brain Biochemistry for a Better Understanding of Pathomechanisms of Acute Brain Injury
title_sort cerebral microdialysis going deep into brain biochemistry for a better understanding of pathomechanisms of acute brain injury
topic cerebral microdialysis
severe traumatic brain injury
decompressive craniectomy
ischemia
mitochondrial dysfunction
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606310
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AT annateresamazzeo cerebralmicrodialysisgoingdeepintobrainbiochemistryforabetterunderstandingofpathomechanismsofacutebraininjury