On the Nature of Brain Stem Disorders in Severe Head Injured Patients

Overview

Journal Acta Neurochir (Wien)

Specialty Neurosurgery

Date 1976 Jan 1

PMID 961474

Citations 1

Authors

C J Vecht

T C van Woerkom

A W Teelken

J M MINDERHOUD

Affiliations

Soon will be listed here.

Abstract

In head injured patients changes were found in the CSF levels of metabolites of the dopaminergic and the serotonergic neurotransmission (HVA and 5-HIAA). After the fifth day following trauma a significant decrease of the HVA levels in the lumbar CSF after probenecid treatment was found. The intensity of this decrease was found to be related to the severity of the trauma (period of unconsciousness), but not to the state of consciousness. Also the probenecid-induced 5-HIAA levels in conscious patients were decreased after the fifth post-traumatic day. In unconscious patients, the period of unconsciousness, particularly in the period of 5-20 days after trauma. Between 21 and 60 days after trauma the 5-HIAA concentrations in unconscious patients decreased remarkably, but they were still significantly higher than in the conscious patients. It can be concluded that during unconsciousness serotonergic neurons have a high rate of turnover, but that both neurotransmitter systems are damaged by the direct or indirect consequences of the injury.

Citing Articles

Executive (dys)function after traumatic brain injury: special considerations for behavioral pharmacology.

Ozga J, Povroznik J, Engler-Chiurazzi E, Vonder Haar C Behav Pharmacol. 2018; 29(7):617-637.

PMID: 30215621 PMC: 6155367. DOI: 10.1097/FBP.0000000000000430.

References

Olsson R, ROOS B . Concentrations of 5-hydroxyindoleacetic acid and homovanillic acid in the cerebrospinal fluid after treatment with probenecid in patients with Parkinson's disease. Nature. 1968; 219(5153):502-3. DOI: 10.1038/219502a0. View

Neef N, Tozer T, Brodie B . Application of seady-state kinetics to studies of the transfer of 5-hydroxyindoleacetic acid from brain to plasma. J Pharmacol Exp Ther. 1967; 158(2):214-8. View

HEISKANEN O, Sipponen P . Prognosis of severe brain injury. Acta Neurol Scand. 1970; 46(3):343-8. DOI: 10.1111/j.1600-0404.1970.tb05798.x. View

Sampath S, Neff N . The elimination of 5-hydroxyindoleacetic acid from cerebrospinal fluid: characteristics of the acid transport system of the choroid plexus. J Pharmacol Exp Ther. 1974; 188(2):410-4. View

Lakke J, Korf J, van Praag H, MINDERHOUD J, SCHUT T . Clinical significance of probenecid test. Lancet. 1973; 1(7803):614-5. DOI: 10.1016/s0140-6736(73)90770-8. View

SACHS Jr E . Acetylcholine and serotonin in the spinal fluid. J Neurosurg. 1957; 14(1):22-7. DOI: 10.3171/jns.1957.14.1.0022. View

Moir A, Ashcroft G, Crawford T, Eccleston D, Guldberg H . Cerebral metabolites in cerebrospinal fluid as a biochemical approach to the brain. Brain. 1970; 93(2):357-68. DOI: 10.1093/brain/93.2.357. View

Johannsson B, ROOS B . 5-Hydroxyindoleacetic acid and homovanillic acid in cerebrospinal fluid of patients with neurological diseases. Eur Neurol. 1974; 11(1):37-45. DOI: 10.1159/000114304. View

Carlsson C, VON ESSEN C, Lofgren J . Factors affecting the clinical corse of patients with severe head injuries. 1. Influence of biological factors. 2. Significance of posttraumatic coma. J Neurosurg. 1968; 29(3):242-51. DOI: 10.3171/jns.1968.29.3.0242. View

10.

Guldberg H, Ashcroft G, Crawford T . Concentrations of 5-hydroxyindolylacetic acid and homovanillic acid in the cerebrospinal fluid of the dog before and during treatment with probenecid. Life Sci. 1966; 5(17):1571-5. DOI: 10.1016/0024-3205(66)91026-5. View

11.

Garelis E, Young S, Lal S, Sourkes T . Monoamine metabolites in lumbar CSF: the question of their origin in relation to clinical studies. Brain Res. 1974; 79(1):1-8. DOI: 10.1016/0006-8993(74)90562-9. View

12.

Jacobson S . Protracted unconsciousness due to closed head injury. Neurology. 1956; 6(4):281-7. DOI: 10.1212/wnl.6.4.281. View

13.

BOWERS Jr M . CSF homovanillic acid: effects of probenecid and alpha-methyltyrosine. Life Sci I. 1970; 9(12):691-4. View

14.

van Praag H, Korf J, Schut D . Cerebral monoamines and depression. An investigation with the Probenecid technique. Arch Gen Psychiatry. 1973; 28(6):827-31. DOI: 10.1001/archpsyc.1973.01750360053007. View

15.

Osterholm J, Bell J, Meyer R, Pyenson J . Experimental effects of free serotonin on the brain and its relation to brain injury. 1. The neurological consequences of intracerebral serotonin injections. 2. Trauma-induced alterations in spinal fluid and brain. 3. Serotonin-induced cerebral edema. J Neurosurg. 1969; 31(4):408-12. DOI: 10.3171/jns.1969.31.4.0408. View

16.

MUNRO H, Fernstrom J, Wurtman R . Insulin, plasma aminoacid imbalance, and hepatic coma. Lancet. 1975; 1(7909):722-4. DOI: 10.1016/s0140-6736(75)91632-3. View

17.

Knell A, Davidson A, Williams R, Kantamaneni B, Curzon G . Dopamine and serotonin metabolism in hepatic encephalopathy. Br Med J. 1974; 1(5907):549-51. PMC: 1633670. DOI: 10.1136/bmj.1.5907.549. View

18.

Curzon G, Kantamaneni B, Winch J, Murray-Lyon I, Williams R . Plasma and brain tryptophan changes in experimental acute hepatic failure. J Neurochem. 1973; 21(1):137-45. DOI: 10.1111/j.1471-4159.1973.tb04233.x. View

19.

Vecht C, van Woerkom T, Teelken A, MINDERHOUD J . 5-Hydroxy indoleacetic acid (5-HIAA) levels in the cerebrospinal fluid in consciousness and unconsciousness after head injury. Life Sci. 1975; 16(7):1179-85. DOI: 10.1016/0024-3205(75)90201-5. View

20.

Teasdale G, Jennett B . Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974; 2(7872):81-4. DOI: 10.1016/s0140-6736(74)91639-0. View