Alcohol-associated acute head trauma in human subjects is associated with early deficits in serum ionized Mg and Ca

Abstract

Acute head trauma (AHT) (caused by motor vehicle accidents that did not produce loss of consciousness or observed brain lesions on CT scan, or falls) was found to result in early (1–8 h after injury) serum deficits in ionized magnesium (IMg 2+) and ionized calcium (ICa 2+) assessed with ion-selective electrodes (ISEs). Total Mg (TMg) and other electrolytes as well as serum biochemical analytes were all within the normal reference ranges. AHT patients with acute alcohol intoxication (BAC ≥ 150 mg/dl) or alcohol abuse (BAC > 200 mg/dl) demonstrated deficits (15–35% less than normal) in IMg 2+, but serum TMg levels were normal as were electrolytes and serum biochemical analytes. AHT patients with alcohol intoxication or alcohol abuse required hospitalization for 1–3 days prior to release, whereas AHT patients without alcohol intoxication were released in less than 24 h. The ICa 2+/IMg 2+ ratio, a sign of increased vascular tone and vascular reactivity, was significantly elevated in AHT patients with alcohol intoxication but not in AHT patients without alcohol intoxication or abuse. These serum divalent cation changes early after traumatic brain injury could be of considerable practicable diagnostic value in the assessment of alcohol-associated head injury. Use of ion-selective electrodes to accurately measure IMg 2+ could serve as a logical basis for monitoring the response of the body to AHT.