Cerebral extraction of oxygen, lactate production, and perfusion pressure in gunshot wound to the head: case report.
A case of gunshot wound to the head is presented, in which the patient made a satisfactory recovery after a prolonged period of elevated intracranial pressure and increased cerebral extraction of oxygen. Even though cerebral extraction of oxygen was increased in the most acute phase, the arteriojugular lactate difference was never abnormally decreased (ischemic). This finding indicated that, in this patient, increased cerebral extraction of oxygen was not sufficient to result in global cerebral ischemia (increased cerebral lactate production). To our knowledge, this is the first report on frequent serial assessment of cerebral extraction of oxygen and lactate production in severe penetrating head injury.
Cruz
J
J
Department of Neurosurgery, Medical College of Pennsylvania and Hahnemann University, Philadelphia, PA 19102-1192, USA.
Zager
E L
EL
Sinson
G P
GP
Hoffstad
O J
OJ
D000328:Adult; D001784:Blood Gas Analysis; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D002545:Brain Ischemia / Q000209:etiology; D002560:Cerebrovascular Circulation; D006801:Humans; D007773:Lactates / Q000096:biosynthesis; D019344:Lactic Acid; D008297:Male; D010101:Oxygen Consumption; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*
D007773:Lactates; D019344:Lactic Acid