Pathophysiological correlates of cerebral ischemia the significance of cellular acid base shifts.

In vivo 31-Phosphorus nuclear magnetic resonance (31PNMR) spectroscopy was used to study regional high energy phosphate, and phospholipid metabolism together with intracellular pH in patients with acute hemispheric ischemic stroke. The pH of ischemic brain progressed from acidosis to alkalosis. Acidosis was correlated with metabolic deterioration. Alkalosis was correlated with poor neurological outcome. Hyperglycemia worsened acidosis and metabolic breakdown. Therapeutic control of systemic glucose levels and cerebral acidosis should be evaluated in acute stroke.