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We conducted retrospective analyses from 44 poor-grade ASAH patients and analyzed glucose, lactate, pyruvate, and glutamate concentrations in control patients without DCI (n\u2009=\u200919), and in patients with DCI whose CMD probe was located within (n\u2009=\u200917) or outside (n\u2009=\u20098) a new infarct. When monitored from within a lesion, DCI was preceded by a decrease in glucose and a surge in glutamate, accompanied by increases in lactate\/pyruvate and lactate\/glucose ratios whereas these parameters remained stable in control patients. When CMD monitoring was performed outside the lesion, the glutamate surge was absent, but glucose and L\/G ratio were still significantly altered. Overall, glucose and L\/G ratio were significant biomarkers of DCI (se96.0, spe73.7-68.4). Glucose and L\/G predicted DCI 67\u2009h before CT detection of a new infarct. The pathogenesis of DCI therefore induces early metabolic disturbances that can be detected by CMD as an advance warning. Glucose and L\/G could provide a trigger for initiating further examination or therapy, earlier than when guided by other monitoring techniques.<\/jats:p>","DOI":"10.1177\/0271678x231193661","type":"journal-article","created":{"date-parts":[[2023,8,12]],"date-time":"2023-08-12T09:29:40Z","timestamp":1691832580000},"page":"1967-1982","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Early brain metabolic disturbances associated with delayed cerebral ischemia in patients with severe subarachnoid hemorrhage"],"prefix":"10.1177","volume":"43","author":[{"given":"Yannick","family":"Tholance","sequence":"first","affiliation":[{"name":"Institut NeuroMyoG\u00e8ne, INSERM U1217\/CNRS UMR 5310, Universit\u00e9 de Lyon, Universit\u00e9 Claude Bernard Lyon 1, Lyon, France"},{"name":"Department of Biochemistry, University Hospital, Saint-Etienne, 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