Current diagnostic tools to assess neurological injury after aneurysmal subarachnoid hemorrhage (aSAH) and traumatic brain injury (TBI) have poor discriminatory abilities. Free radicals are associated with the pathophysiology of secondary damage after brain trauma. We examined cerebrospinal fluid (CSF) lipid markers of oxidative stress, isofurans (IsoFs), F 4 -neuroprostanes (F 4 -NeuroPs), and F 2 -isoprostanes (F 2 -IsoPs), in two casecontrolled studies in patients with aSAH or severe TBI. Patients with aSAH (n = 18) or TBI (n = 18) were age and gender matched with separate control groups. CSF samples were collected from patients within 24 h of the injury. CSF IsoFs and F 4 -NeuroPs were increased in aSAH patients compared with their controls. In TBI patients, IsoFs and F 4 -NeuroPs were increased compared with their controls. F 2 -IsoPs were increased in aSAH patients, but not in TBI patients, compared with their respective controls. CSF IsoFs and F 4 -NeuroPs are consistently increased after a catastrophic central nervous system injury. These results suggest their measurement may enhance the management of unconscious patients in neurological care. Antioxid. Redox Signal. 15, 2663-2667.
Brain Injury and Oxidative StressA neurysmal subarachnoid hemorrhage (aSAH) and traumatic brain injury (TBI) are associated with devastating central nervous system (CNS) injury. aSAH is associated with a high mortality rate and substantial lifelong morbidity in survivors. TBI is a major health and socioeconomic problem more prevalent in young male adults. The most common secondary injury resulting from aSAH and TBI is attributable to vasospasm-induced microvascular injury and cerebral ischemia. Diagnostic tools use surrogate measures such as intracranial pressure changes and interval changes in neuroimaging, which have poor discriminatory abilities.After acute brain injury, there is a disruption of calcium homeostasis, excitotoxicity from release of neurotransmitters such as glutamate, overproduction of reactive oxygen species (ROS), and opening of the mitochondrial permeability transition pore, all key factors in promoting mitochondrial
InnovationAneurysmal subarachnoid hemorrhage (aSAH) and traumatic brain injury (TBI) associate with catastrophic central nervous system (CNS) injury. Diagnostic tools to assess neurological injury after aSAH and TBI currently have poor discriminatory capacity. Free radicals are likely to be involved in mediating secondary damage after brain trauma. In two case-controlled studies of patients with aSAH or severe TBI, we examined lipid markers of oxidative stress, isofurans (IsoFs), F 4 -neuroprostanes (F 4 -NeuroPs), and F 2 -isoprostanes (F 2 -IsoPs), in cerebrospinal fluid (CSF) samples. In aSAH and TBI patients, IsoFs and F 4 -NeuroPs were increased compared with their respective controls. F 2 -IsoPs were increased in aSAH patients, but not in TBI patients. Increased IsoFs and F 4 -NeuroPs in the CSF of these patients is a new and important finding that may have important clinical imp...