Patients and Interventions. Tissue damage caused by brain retraction was evaluated utilizing intracerebral microdialysis in six patients operated on subfrontally for pituitary adenoma. The microdialysis probes (membrane length 10 mm, cut-off 20 kDalton) were placed in cerebral cortex beneath the brain retractor and perfused with Ringer solution at 0.3 mul/min. The microdialysis vials were changed at intervals of 30 minutes and analysed for glucose, pyruvate, lactate, glutamate and glycerol. Results. During brain retraction regional intracerebral glucose was within normal range in cortical tissue and the levels of lactate, glutamate, and glycerol as well as the lactate/pyruvate ratio were considerably above normal range. Conclusion. The biochemical analysis shows a pronounced incomplete cerebral ischemia due to brain retraction. The increases in glutamate and glycerol indicate tissue damage and degradation of cell membranes. Intracerebral microdialysis may be a valuable tool in the development of optimal techniques for brain retraction during neurosurgical procedures.
基金:
The study was supported
by grants from the Segerfalk Foundation, The Laerdal Foundation,the Swedish Medical Research Council (14X-003574-28D), and
Lund University Hospital.
第一作者机构:[1]Kunming Med Coll, Intens Care Unit, First Affiliated Hosp, Kunming, Yunnan Province, Peoples R China;
通讯作者:
通讯机构:[4]Univ Lund Hosp, Dept Neurosurg, S-22185 Lund, Sweden
推荐引用方式(GB/T 7714):
Xu W,Mellergard P,Ungerstedt U,et al.Local changes in cerebral energy metabolism due to brain retraction during routine neurosurgical procedures[J].ACTA NEUROCHIRURGICA.2002,144(7):679-683.doi:10.1007/s00701-002-0946-1.
APA:
Xu, W,Mellergard, P,Ungerstedt, U&Carl-Henrik Nordstrom.(2002).Local changes in cerebral energy metabolism due to brain retraction during routine neurosurgical procedures.ACTA NEUROCHIRURGICA,144,(7)
MLA:
Xu, W,et al."Local changes in cerebral energy metabolism due to brain retraction during routine neurosurgical procedures".ACTA NEUROCHIRURGICA 144..7(2002):679-683