No shinkei geka. Neurological surgery
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Review Case Reports
[Use of intracerebral microdialysis in severe traumatic brain injury].
Brain microdialysis (MD) is a well-established technique to monitor the chemistry of the extracellular space in the brain during neurointensive care. MD may be useful in severe cases of traumatic brain injury (TBI) in which monitoring of intracranial pressure and cerebral perfusion pressure is required. Lactate/pyruvate (L/P) ratio, glucose, glutamate, and glycerol can be measured using a bedside device. ⋯ Our preliminary results indicate that MD L/P ratios are higher and more fluctuated in poor outcome patients compared to those in favorable outcome patients. MD in association with other brain monitoring techniques is safe and may be useful in preventing and relieving secondary ischemic injury, predicting outcome and guiding therapy after severe TBI. However, the value of MD as a tool in routine neurointensive care decision-making remains unclear.