In recent years much progress has been made in the field of neurochemical monitoring for the acutelly injured brain. The development of safe continuous microdialysis techniques coupled with microanalytical methodology can generate semi-continuous time profiles of the changes in numerous brain analytes such as lactate, glucose, pyruvate, excitatory amino acids, structural amino acids, indicators of free radical generation, cytokines, adenosine, and neuroprotective drugs. Descriptive studies have shown profound, prolonged, and severe abnormalities in many of the analytes measured and the next phase is to determine the effects of therapeutic interventions upon these parameters. This field of research has contributed tremendously to our understanding of pathomechanisms in acute human brain damage.
Methodology and Animal Studies: Theory and Practice of Microdialysis – Prospect for Future Clinical Use (L. Hillered, L. Persson); Unbound Plasma Concentrations May Predict Neuroprotective Brain Concentrations: A Brain Microdialysis and Pharmacokinetic Study of Enadoline in Rats (J. P. Hinton, G. Hudson); Intraoperative Enzyme-Amperometric Monitoring of Extracellular Glutamate Concentration with a Dialysis Electrode in Ischemic Human Brain (T. Kawamata, Y. Katayama, M. Satoh, T. Mori, T. Maeda).- Glutamate and Energy Metabolites in Severe Human Head Injury: CSF and ECF Glutamate Concentrations in Elead Injured Patients (T. Yamamoto, S. Rossi, M. Stiefel, E. Doppenberg, A. Zauner, R. Bullock, A. Marmarou); Glucose and Lactate Metabolism after Severe Human Head Injury: Influence of Excitatory Neurotransmitters and Injury Type (B. Alessandri, E. Doppenberg, R. Bullock, J. Woodward, S. Choi, S. Koura, H. F. Young); Evidence for Time-Dependent Glutatmate-Mediated Glycolysis in Head-Injured Patients: A Microdialysis Study (B. Alessandri, E. Doppenberg, A. Zauner, J. Woodward, S. Choi, R. Bullock).- Ionic Changes in Severe Human Head Injury: Determinants of Cerebral Extracellular Potassium after Severe Human Head Injury (E. M. R. Doppenberg, M. Reinert, A. Zauner, T. S. Massie, R. Bullock); Simultaneous Measurement of Cortical Potassium, Calcium, and Magnesium Levels Measured in Head Injuried Patients Using Microdialysis with Ion Chromatography (J. C. Goodman, A. B. Valadka, S. P. Gopinath, M. Uzura, R G. Grossmann, C. S. Robertson).- Oxygen, Carbondioxide and pH in Severe Human Head Injury: What does Measurement of Brain Tissue pO2, pCO2 & pH Add to Neuromonitoring? (F. T. Charbel, W. E. Hoffman, M. Misra, T. Nabhani, J. I. Ausman); Effect of Hypocapnea on CBF and Extracellular Intermediates of Secondary Brain Injury (P. B. Letarte, A. M. Puccio, S. D. Brown, D. W. Marion); Continuous Monitoring of Cerebrospinal Fluid Acid-Base Balance and Oxygen Metabolism in Patientswith Severe Head Injury: Pathophysiology and Treatments for Cerebral Acidosis and Ischemia (T. Shiogai, I. Nara, K. Saruta, M. Hara, I. Saito); Monitoring by Subcutaneous Microdialysis in Neurosurgical Intensive Care (P. J. A. Hutchinson, M. T. O’Connell, L. B. Maskell, J. D. Pickard).- Multiparametric Systems in Severe Human Head Injury: Brain Viability and Function Analyzer: Multiparametric Real-Time Monitoring in Neurosurgical Patients (A. Mayevsky, A. Doron, S. Meilin, T. Manor, E. Ornstein, G. E. Ouaknine); Importance of Metabolic Monitoring Systems as an Early Prognostic Indicator in Severe Head Injured Patients (H. Kushi, T. Moriya, T. Saito, K. Kinoshita, T. Shibuya, N. Hayashi).