title: Cerebral Metabolism and the Role of Glucose Control in Acute Traumatic Brain Injury.
abstract: This article reviews key concepts of cerebral glucose metabolism, neurologic outcomes in clinical trials, the biology of the neurovascular unit and its involvement in secondary brain injury after traumatic brain insults, and current scientific and clinical data that demonstrate a better understanding of the biology of metabolic dysfunction in the brain, a concept now known as cerebral metabolic energy crisis. The use of neuromonitoring techniques to better understand the pathophysiology of the metabolic crisis is reviewed and a model that summarizes the triphasic view of cerebral metabolic disturbance supported by existing scientific data is outlined. The evidence is summarized and a template for future research provided.
authors.affiliation: Division of Neurocritical Care, Department of Neurosurgery, University of California Los Angeles, 757 Westwood Boulevard, Los Angeles, CA 90095, USA. Electronic address: mblanco@mednet.ucla.edu.
authors.forename: Manuel M
authors.initials: MM
authors.lastname: Buitrago Blanco
authors.affiliation: Division of Neurocritical Care, Department of Neurosurgery, University of California Los Angeles, 757 Westwood Boulevard, Los Angeles, CA 90095, USA.
authors.forename: Giyarpuram N
authors.initials: GN
authors.lastname: Prashant
authors.affiliation: Division of Neurocritical Care, Department of Neurosurgery, University of California Los Angeles, 757 Westwood Boulevard, Los Angeles, CA 90095, USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Vespa
mesh_terms: D001921:Brain / Q000378:metabolism*; D001930:Brain Injuries / Q000378:metabolism*; D000070642:Brain Injuries, Traumatic / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism*; D006801:Humans
chemical_list: D005947:Glucose
keywords: Cerebral microdialysis; Glucose control; Hyperglycolysis; Metabolic crisis; Metabolism; Neurovascular unit; Outcome; Traumatic brain injury