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Metabolic Changes of the Brain after Subarachnoid Haemorrhage
 Adamkov, Jaroslav ; Náhlovský, Jiří (advisor) ; Krahulík, David (referee) ; Smrčka, Martin (referee)
Metabolic changes in the brain after subarachnoid haemorrhage. Summary The goal of the study: The goal of this study is to set concentrations of energetic metabolites in the acute phase (first 24 hours of monitoring) after subarachnoid haemorrhage (SAH) and to define the relation of these concentrations to the clinical and imaging parameters on admi-ssion and final clinical state of the patient one month after the bleeding. Throughout the period of monitoring, in all patients we observed episodes of lactate/pyruvate (L/P) ratio > 30 and their relation to actual readings of intracranial pressure (ICP) and perfuse pressure (CPP). We also monitored concentrations of glycerol in two compartments (brain interstitium and serum). Type of the study: Retrospective clinical study The set and methodology: From 2012 to 2015 we introduced a microdialysis catheter and a sensor for measuring ICP within a multimodal monitoring in 15 patients after subarachnoid bleeding. We performed this multimodal monitoring for a period of 84 days and processed in aggregate 10,080 readings. In 7 patients, together with multimodal monitoring, we also determined the serum concentration of glycerol. The onset of monitoring was always connected with obliteration of the source of bleeding either via surgery or endovascular procedure. Results:...
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