The Effects of Head Trauma and Brain Injury on Neuroendocrinologic Function
Abstract
During the first year of this contract, 79 patients have been studied, 37 of whom had acute severe brain injury following injury. In four patients, associated spinal cord injury or intracranial bleeds were present. Forty-two control patients having a variety of acute medical/surgical problems were followed. Attention has been focused on the use of catecholamines as predictors of patient outcome. We have determined that a gradient exists in sympathetic nervous system activation after head trauma indicating that peripheral neurohumoral markers, particularly norepinephrine reflect the extent of brain injury. It was also determined that markedly elevated norepinephrine levels within 48 hours of severe brain injury suggests little improvement in neurologic function within the first week of injury. In contrast patients with comparable neurologic deficits, but only modest elevated norepinephrine levels, have significant neurologic improvement. Two different studies on the effects of brain injury on neuroendocrine function have been completed and a third started. In the first, it was found that patients with increased intracranial pressure and intact brain stem function failed to suppress circulating cortisol levels despite massive dosage of glucocorticoids. This is in contradistinction to patients with increased intracranial pressure and abnormal brain stem function and those in whom intracranial pressure was normal, all of whom had low cortisol concentrations. The patients with nonsuppressed cortisols had low and not high ACTH levels.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 13, 1984
- Accession Number
- ADA172438
Entities
People
- Paul D. Woolf
- Robert W. Hamill
Organizations
- University of Rochester Medical Center