Early cerebral hyperglycolysis after subarachnoid haemorrhage correlates with favourable outcome

Acta Neurochir (Wien). 2002 Nov;144(11):1121-31. doi: 10.1007/s00701-002-1011-9.


Background: Intracerebral microdialysis (MD) was applied in patients with severe subarachnoid haemorrhage treated in a neurosurgical intensive care unit in order to explore their cerebral energy metabolism.

Method: Brain MD fluid levels of glucose, lactate and pyruvate were measured for 3 to 12 days in 20 patients and 2,635 hourly samples were analysed. The MD data were related to computerized tomography and clinical outcome, assessed by the Glasgow Outcome Scale.

Findings: The study showed that most patients who made a good recovery had a specific curve pattern when plotting the studied metabolites over time, characterised by a distinct decrease in MD-glucose and a parallel increase in both MD-lactate and pyruvate. Patients who had an unfavourable outcome lacked this distinct curve pattern and exhibited more irregular changes, including increased levels of both MD-glucose and lactate and low MD-pyruvate levels.

Interpretation: This exploratory study suggests that accumulation of interstitial lactate and pyruvate, together with decreasing levels of glucose is a favourable prognostic pattern presumably reflecting increased glucose metabolism. Such hyperglycolysis may be elicited in patients with recovery potential to cope with an extreme metabolic demand set in motion by a brain insult to restore brain cell homeostasis and integrity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose / metabolism
  • Brain / physiopathology*
  • Embolization, Therapeutic
  • Energy Metabolism / physiology*
  • Female
  • Glasgow Outcome Scale
  • Glycolysis / physiology*
  • Humans
  • Intracranial Aneurysm / mortality
  • Intracranial Aneurysm / physiopathology*
  • Intracranial Aneurysm / therapy
  • Lactic Acid / metabolism
  • Male
  • Microdialysis
  • Microsurgery
  • Middle Aged
  • Prognosis
  • Pyruvic Acid / metabolism
  • Subarachnoid Hemorrhage / mortality
  • Subarachnoid Hemorrhage / physiopathology*
  • Subarachnoid Hemorrhage / therapy
  • Survival Rate


  • Blood Glucose
  • Lactic Acid
  • Pyruvic Acid