Surgical Management After Brain Hypothermia Treatment to Prevent Vegetation and Memory Disturbance

Abstract

The analysis of neurotransmitters in the cerebrospinal fluid (CSF) provides much information about neuronal function and CBF disturbances. The neurotransmitter levels in the cortex such as those of dopamine, norepinephrine, and serotonin will be changed in the CSF by damage to brain tissue. However, the background and meaning of CSF neurotransmitters are not simple. We have recorded two types of neuronal dysfunction with changes of CSF neurotransmitters [1]. One is very low levels of neurotransmitters in the CSF and the other is high levels in the CSF of vegetative patients. Reduced neurotransmitter levels in CSF at the vegetative state can be explained as a result of massive neuronal loss or reduced neuronal activity. Some patients in this group could respond to neurotransmitter replacement therapy. The reversibility of vegetative patients is diagnosed with simultaneous increases of the CSF dopamine/prolactin ratio and CSF neurotransmitter level as described in Chap. 50.