Summary.
Summary.
Patients and Interventions:
Tissue damage caused by brain retraction was evaluated utilizing intracerebral microdialysis in six patients operated on subfrontally for pituitary adenoma. The microdialysis probes (membrane length 10 mm, cut-off 20 kDalton) were placed in cerebral cortex beneath the brain retractor and perfused with Ringer solution at 0.3 μl/min. The microdialysis vials were changed at intervals of 30 minutes and analysed for glucose, pyruvate, lactate, glutamate and glycerol.
Results:
During brain retraction regional intracerebral glucose was within normal range in cortical tissue and the levels of lactate, glutamate, and glycerol as well as the lactate/pyruvate ratio were considerably above normal range.
Conclusion:
The biochemical analysis shows a pronounced incomplete cerebral ischemia due to brain retraction. The increases in glutamate and glycerol indicate tissue damage and degradation of cell membranes. Intracerebral microdialysis may be a valuable tool in the development of optimal techniques for brain retraction during neurosurgical procedures.
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Published online July 18, 2002 © Springer-Verlag 2002
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Xu, W., Mellergård, P., Ungerstedt, U. et al. Local Changes in Cerebral Energy Metabolism due to Brain Retraction During Routine Neurosurgical Procedures. Acta Neurochir (Wien) 144, 679–683 (2002). https://doi.org/10.1007/s00701-002-0946-1
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DOI: https://doi.org/10.1007/s00701-002-0946-1