Detecting metabolic and cognitive alterations after surgery and acute brain injury

This dissertation focuses on metabolic and cognitive alterations after surgery and acute brain injury.
Part I focuses on cerebral glucose metabolism. We describe the various changes in glucose metabolism following acute brain injury. We show that cerebrospinal fluid levels of polyols are not elevated after acute brain injury.
Part II focuses on postoperative neurocognitive disorders (PNCD). We systematically reviewed the literature and found no association between intraoperative hypotension and PNCD in older adults. We discussed methods to detect postoperative cognitive changes in this population. We found that two currently existing short detection tools are unreliable for detecting PNCD compared to the gold standard neuropsychological assessment. Furthermore, adjusting the outcome scores of one of these existing tools for age, sex, and educational level did not increase its reliability. We developed a short test battery for the detection of PNCD by selecting the most predictive tests from the gold standard assessment. This test battery needs to be validated in further research.