Systemic Nitrosative/Oxidative Stress in Patients With Acute Brain Injury

Acute brain injury due to traumatic brain injury (TBI), intracerebral haemorrhage (ICH), and aneurysmal subarachnoid haemorrhage (SAH) carries a high morbidity and mortality, in part due to the development of secondary brain injury. The mechanisms behind secondary brain injury are incompletely understood, but oxidative/nitrosative stress and disturbances in the metabolism of the vasodilator nitric oxide (NO) are believed to be involved. The aim of the present study is to characterise systemic changes in markers of oxidative/nitrosative stress and NO metabolism in the early phase after acute brain injury, and to examine their relationship to clinical course, neurological outcome, and mortality.

Inclusion Criteria: * Admission to the Neurointensive Care Unit (NICU) at Rigshospitalet * Diagnosis of TBI, spontaneous ICH or aneurysmal SAH * Initiation of blood sampling possible within 3 days after ictus * Expected length of stay in the NICU and/or intermediate care unit of ≥48 hours * Closest relatives understand written and spoken Danish Exclusion Criteria: * Brain death before inclusion * Expected death within 24 hours * ICH secondary to other causes (e.g., a tumour or arteriovenous malformation) * SAH secondary to other causes (e.g., a mycotic aneurysm or arteriovenous malformation)