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Objective:

To determine whether persistent metabolic dysfunction in normal-appearing frontal lobe tissue is correlated with long-term tissue atrophy.

Design:

Prospective monitoring with retrospective data analysis.

Setting:

Single-center academic neurointensive care unit.

Patients:

Fifteen patients with moderate to severe traumatic brain injury (Glasgow Coma Scale score 3–12).

Interventions:

None.

Measurements and Main Results:

Hourly cerebral microdialysis was performed for the initial 96 hrs after trauma to determine extracellular levels of glucose, glutamate, glycerol, lactate, and pyruvate in normal appearing frontal lobes. Six months after injury, the anatomical outcome was assessed by measures of global and regional cerebral atrophy using volumetric brain magnetic resonance imaging. The lactate/pyruvate ratio was elevated> 40 after traumatic brain injury in most patients, with a mean percent time of 32±29% of …