Tissue lactate in pediatric head trauma: a clinical study using 1H NMR spectroscopy

In order to define the metabolic abnormalities associated with different types of pediatric head injury, proton magnetic resonance spectroscopy was performed on 21 cerebral regions obtained from 17 patients. On the basis of MRI scans, the regions of interest were classified as normal (6 hemispheres), or showing diffuse axonal injury (3 hemispheres), contusion (4 hemispheres), or cerebral infarction (8 hemispheres). In comparison with normal brain there was no significant elevation in tissue lactate in the diffuse axonal injury patients, but a significant increase in the regions of contusion and infarction. It is concluded that treatment strategies using buffering agents are most likely to benefit these two groups of patients.