Prolonged elevation of magnesium in the cerebrospinal fluid of patients with severe head injury.
OBJECTIVE
Several works have investigated the role of serum magnesium (Mg) concentrations in traumatic brain injury. However, there is restricted information about cerebrospinal fluid (CSF) levels of Mg in patients with severe head injury (SHI). We assessed the changes of Mg concentrations in CSF and serum in patients with SHI during the first 10 days after the trauma.


METHODS
Eleven patients with SHI were studied prospectively on days 1-3, 5 and 10 with analysis of CSF and serum levels of Mg and Ca. The control group consisted of nine patients with hydrocephalus.


RESULTS
CSF levels of Mg were significantly higher in patients than controls in the corresponding time points except on days 5 and 10 of trauma. The CSF Mg levels tended to decrease and the highest level was found on day 1 after trauma (2.81 +/- 0.65 mg/dl). In the control group, the CSF level of Mg was 1.95 +/- 0.66 mg/dl. No significant difference can be detected between controls and patients regarding serum Mg and Ca levels. In addition, significantly higher values of Ca in the CSF were observed in all time points after trauma in patients with SHI than in the controls. There was no correlation between the CSF and serum levels of Mg and Ca levels.


CONCLUSIONS
Our study demonstrates that in patients with SHI, CSF levels of Mg and Ca are elevated during the whole observation period. Further works should be designed in order to show the role and importance of CSF levels of ionized Mg in outcome of patients with SHI.
Kafadar
Ali Metin
AM
Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. kafadar@istanbul.edu.tr
Sanus
Galip Zihni
GZ
Is
Merih
M
Coskun
Abdurrahman
A
Tanriverdi
Taner
T
Hanimoglu
Hakan
H
Uzan
Mustafa
M
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001784:Blood Gas Analysis; D006259:Craniocerebral Trauma / Q000097:blood / Q000134:cerebrospinal fluid*; D018450:Disease Progression; D004573:Electrolytes / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008274:Magnesium / Q000097:blood / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D004573:Electrolytes; D008274:Magnesium