Plasma vitamin C levels are decreased and correlated with brain damage in patients with intracranial hemorrhage or head trauma

Background and Purpose-Free radical hyperproduction may play an important r ole in brain hemorrhage and ischemia/reperfusion injury. The aims of this s tudy were to assess whether antioxidant depletion occurs after intracranial hemorrhage (ICH) and head trauma (HT) and to evaluate the relation between the diameter of the brain lesion, the degree of the neurological impairmen t, and any observed antioxidant changes. Methods-We measured plasma levels of vitamin C (ascorbic acid, AA), uric ac id (UA), vitamin E (alpha -tocopherol), and ubiquinol-10 in 13 patients wit h ICH and 15 patients with HT on the day of the brain injury and subsequent ly every other day up to 1 week. Patients were compared with 40 healthy con trol subjects. Results-ICH and HT patients had significantly lower plasma levels of AA com pared with healthy subjects, in contrast to plasma levels of UA, alpha -toc opherol, and ubiquinol-10. AA levels were significantly inversely correlate d with the severity of the neurological impairment as assessed by the Glasg ow Coma Scale and the National Institutes of Health Stroke Scale. AA levels were also significantly inversely correlated with the major diameter of th e lesion. In addition, mean plasma AA levels were lower in jugular compared with peripheral blood samples obtained from 5 patients. Conclusions-These findings suggest that a condition of oxidative stress occ urs in patients with head trauma and hemorrhagic stroke of recent onset. Th e consequences of early vitamin C depletion on brain injury as well as the effects of vitamin C supplementation in ICH and HT patients remain to be ad dressed in further studies.