Probing the mysterious second-wave of damage in head injury patients
Why do some of the one million people who sustain head injuries annually in United States experience a mysterious second wave of brain damage days after the initial injury just when they appear to be recovering? Limited clinical trials using an innovative new device to monitor brain chemistry on a second-by-second basis are underway to answer that life-and-death question, according to an article in the current issue of Chemical & Engineering News (C&EN), ACS' weekly newsmagazine. Brain injury is the leading cause of death and disability worldwide.
C&EN Senior Editor Celia Henry Arnaud describes a phenomenon called depolarization, in which brain activity decreases in patients following initial trauma. The condition involves a wave of chemical changes that spread from the site of injury and inactivate nerve cells. Since reactivation of these cells requires large amounts of glucose, monitoring glucose levels in a patient's brain can help doctors tell whether or not a patient is taking a turn for the worse. The article points out that a promising new device could provide a faster and more useful way to monitor brain glucose than current methods, which are inefficient.
Now in development at Imperial College London, the new so-called "microfluidic method" measures glucose quickly and continuously in fractions of a second instead of hourly. The device is currently being tested in patients who have suffered trauma, stroke, or aneurysm (a balloon-like enlargement of a brain artery). In the future, the device could be used in patients with milder forms of brain injury and used in a way that is less invasive, the article notes.