Plasma vitamin C levels are decreased and correlated with brain damage in patients with intracranial hemorrhage or head trauma.
OBJECTIVE
Free radical hyperproduction may play an important role in brain hemorrhage and ischemia/reperfusion injury. The aims of this study were to assess whether antioxidant depletion occurs after intracranial hemorrhage (ICH) and head trauma (HT) and to evaluate the relation between the diameter of the brain lesion, the degree of the neurological impairment, and any observed antioxidant changes.


METHODS
We measured plasma levels of vitamin C (ascorbic acid, AA), uric acid (UA), vitamin E (alpha-tocopherol), and ubiquinol-10 in 13 patients with ICH and 15 patients with HT on the day of the brain injury and subsequently every other day up to 1 week. Patients were compared with 40 healthy control subjects.


RESULTS
ICH and HT patients had significantly lower plasma levels of AA compared with healthy subjects, in contrast to plasma levels of UA, alpha-tocopherol, and ubiquinol-10. AA levels were significantly inversely correlated with the severity of the neurological impairment as assessed by the Glasgow Coma Scale and the National Institutes of Health Stroke Scale. AA levels were also significantly inversely correlated with the major diameter of the lesion. In addition, mean plasma AA levels were lower in jugular compared with peripheral blood samples obtained from 5 patients.


CONCLUSIONS
These findings suggest that a condition of oxidative stress occurs in patients with head trauma and hemorrhagic stroke of recent onset. The consequences of early vitamin C depletion on brain injury as well as the effects of vitamin C supplementation in ICH and HT patients remain to be addressed in further studies.
Institute of Gerontology and Geriatrics, Perugia University Hospital, Perugia, Italy. polidori@uni-duesseldorf.de
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Polidori
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Mecocci
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Frei
D000328:Adult; D000975:Antioxidants / Q000032:analysis / Q000378:metabolism; D001205:Ascorbic Acid / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D006259:Craniocerebral Trauma / Q000097:blood / Q000175:diagnosis*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D020300:Intracranial Hemorrhages / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood; D014527:Uric Acid / Q000097:blood; D014810:Vitamin E / Q000097:blood
D000975:Antioxidants; D015415:Biomarkers; D014451:Ubiquinone; D014810:Vitamin E; D014527:Uric Acid; C026663:ubiquinol-10; D001205:Ascorbic Acid