Plasma
magnesium,
calcium, and oxidative status were investigated in 31 male casualties with
traumatic brain injury (TBI) during a 7-day posttraumatic period. The study group consisted of eight patients with mild
closed head injury (Glasgow Coma Scale score [GCS] of 13-15), 10 patients with extensive
penetrating head injury (GCS 4-6), and 13 patients with
blast injuries but without direct
head trauma. The latter group was included since previous experimental and clinical data have confirmed the development of indirect
brain trauma in patients with
blast injuries. Patients with
multiple injuries were not included. Significant declines in plasma
divalent cations were found in GCS 4-6 patients immediately after TBI and persisting for the entire 7-day study period. Similar changes in
magnesium, but not
calcium, were present in the GCS 13-15 and the
blast injury groups, but only up until day 3 after injury. Alterations in lipid peroxidation products and
superoxide anions were also observed following TBI. Increased lipid peroxidation was noted in all three groups over the entire posttraumatic period while increases in
superoxide anion generation occurred transiently immediately following TBI. Thereafter, in the GCS 13-15 and
blast injury groups,
superoxide anions subsequently normalized, whereas in extensive
head injury (GCS 4-6),
superoxide anion generation significantly declined. A negative correlation between
magnesium balance and oxidative stress was observed in all patients immediately after injury persisting in GCS 4-6 patients to the end of the observation period. Our findings suggest an interrelationship between
magnesium changes and blood
oxidants/
antioxidants after TBI, which could be of both diagnostic and prognostic value in patients with neurotrauma.