Medknow Publications on behalf of the Neurological Society of India
Abstract
Context: Acute oxidative stress following a traumatic head injury (HI)
has been implicated in inducing severe secondary brain damage and
influencing the clinical outcome of HI patients. Aims: This study was
performed to evaluate and compare the oxidative changes in patients
with varying severity of HI in the early posttraumatic period using
erythrocyte indicators. Settings and Design: Head injury patients were
divided into two groups based on their Glasgow Coma Scale (GCS) scores
recorded at admission to the hospital on the day of trauma itself.
Accordingly, the study included 30 severe HI (SHI, GCS scores 8 or
less) and 25 Mild HI (MHI, GCS scores more than 8) patients. Thirty age
and sex-matched healthy individuals were included in this comparative
study as controls. Materials and Methods: Blood samples were obtained
from controls and HI patients (within 24 h of trauma onset).
Erythrocyte oxidative changes were studied by estimating thiobarbituric
acid reactive substances (TBARS), glutathione (GSH), superoxide
dismutase (SOD) and glutathione reductase (GR). Results: Erythrocyte
TBARS levels were significantly higher and GSH levels were
significantly lower in SHI and MHI patients as compared to controls.
The SOD activity was significantly increased only in SHI patients and
remained unchanged in MHI patients as compared to controls. As compared
to MHI patients, erythrocyte TBARS levels were significantly higher,
GSH levels were significantly lower and SOD activity was markedly
elevated in SHI patients. Erythrocyte GR activity did not show
significant changes in both groups of patients as compared to controls.
Conclusion: Oxidative stress is evident in both SHI and MHI patients
in the early posttraumatic period as reflected by their erythrocyte
indicators, but the severity of oxidative stress has varied relatively
with the severity of head injury. The present findings provide
indications that early oxidative changes could influence the
neurological recovery of HI patients