title: Characterization of the Ionic Profile of the Extracellular Space of the Injured and Ischemic Brain: A Microdialysis Study.
abstract: Traumatic brain injury (TBI) and ischemic stroke cause a variable disruption of ionic homeostasis and massive ionic fluxes with subsequent osmotic water movement across the cells that causes edema, brain swelling, and deformation of the damaged tissue. Although cerebral microdialysis (CMD) has been used to study the brain neurochemistry, the ionic profiles of brain interstitial space fluid have rarely been reported in humans. We studied the ionic profile in injured areas of the brain by using CMD. As a control group, we included seven patients who had undergone surgical treatment of posterior fossa lesions, without abnormalities in the supratentorial compartment. Inductively coupled plasma mass spectrometry (ICP-MS) was used for ion determination. No significant differences were found in the [Na+]o, [K+]o, and [Cl-]obetween normal injured brains and controls. The ionic profile of the ischemic core was characterized by very high [K+]oand an increase in [Na+]o, whereas [Cl-]owas linearly related to [Na+]o. In the traumatic core (TC), significantly higher levels of [Na+]o, [Cl-]o, and [K+]owere found. The main finding in the penumbra was a completely normal ionic profile for [Na+]oand [K+]oin 60% of the samples. ICP-MS coupled to ionic assays creates a powerful tool for a better understanding of the complex ionic disturbances that occur after severe TBI and ischemic stroke.
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Tamara
authors.initials: T
authors.lastname: Martínez-Valverde
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Angela
authors.initials: A
authors.lastname: Sánchez-Guerrero
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Marian
authors.initials: M
authors.lastname: Vidal-Jorge
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .|2 Department of Neurosurgery, Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Ramon
authors.initials: R
authors.lastname: Torné
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Lidia
authors.initials: L
authors.lastname: Castro
authors.affiliation: 2 Department of Neurosurgery, Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Dario
authors.initials: D
authors.lastname: Gandara
authors.affiliation: 3 Department of Anesthesiology, Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Francisca
authors.initials: F
authors.lastname: Munar
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .|2 Department of Neurosurgery, Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Maria-Antonia
authors.initials: MA
authors.lastname: Poca
authors.affiliation: 1 Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .|2 Department of Neurosurgery, Vall d'Hebron University Hospital , Universidad Autònoma de Barcelona, Barcelona, Spain .
authors.forename: Juan
authors.initials: J
authors.lastname: Sahuquillo
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002712:Chlorides / Q000378:metabolism; D005110:Extracellular Space / Q000378:metabolism*; D005260:Female; D006801:Humans; D007473:Ion Channels / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000378:metabolism; D011446:Prospective Studies; D012964:Sodium / Q000378:metabolism; D055815:Young Adult
chemical_list: D002712:Chlorides; D007473:Ion Channels; D012964:Sodium; D011188:Potassium
keywords: TBI; brain microdialysis; ischemic stroke; potassium; sodium