Although much feared by clinicians, the ability to produce
ketones has allowed humans to withstand prolonged periods of
starvation. At such times,
ketones can supply up to 50% of basal energy requirements. More interesting, however, is the fact that
ketones can provide as much as 70% of the brain's energy needs, more efficiently than
glucose. Studies suggest that during times of
acute brain injury, cerebral uptake of
ketones increases significantly. Researchers have thus attempted to attenuate the effects of cerebral injury by administering
ketones exogenously. Hypertonic saline is commonly utilized for management of
intracranial hypertension following cerebral injury. A
solution containing both hypertonic saline and
ketones may prove ideal for managing the dual problems of refractory
intracranial hypertension and low cerebral energy levels. The purpose of the present review is to explore the physiology of
ketone body utilization by the brain in health and in a variety of neurological conditions, and to discuss the potential for
ketone supplementation as a therapeutic option in
traumatic brain injury.