Endocrine response to brain injury

Détails

ID Serval
serval:BIB_00CEC0E2A414
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Endocrine response to brain injury
Périodique
New Horizons
Auteur(s)
Chiolero  R., Berger  M.
ISSN
1063-7389 (Print)
Statut éditorial
Publié
Date de publication
11/1994
Volume
2
Numéro
4
Pages
432-42
Notes
Journal Article
Review --- Old month value: Nov
Résumé
The neuroendocrine response (NER) is an essential component of the adaptive process to trauma, brain injury, and major surgery. While receiving additive humoral and neural afferent inputs, the brain nuclei responsible for the NER act mainly by efferent pathways to the hypothalamic-pituitary-adrenal (HPA) axis and the sympathoadrenal system, the activations of which induce subsequent circulatory and metabolic responses. The NER to brain injury is similar to the response observed in patients with extracerebral injury, even if the response after brain injury is extremely variable. Generally, there is a biphasic pattern, with a sympathoadrenal storm associated with variable and altered stimulation of the HPA during the ebb phase. The first phase is followed by a decrease in both responses while other endocrine changes develop, involving mainly the counter-regulatory, gonadal, and thyroid hormones. The outcome after brain injury is closely correlated with the intensity of these changes, particularly with catecholamine plasma levels and the severity of the low triiodothyronine syndrome. Alterations of the thyroid hormones are largely related to a reduction in peripheral deiodination of thyroxin. Recent research shows that increased free-radical production and decreased selenium (an antioxidant) serum levels play an important role in thyroid metabolism. Two major issues remain unsolved: a) the precise definition of cerebral death, since endocrine brain function is not abolished in the state currently defined as brain death; and b) the question of whether substitutive hormone therapy should be applied in severe brain injury.
Mots-clé
Animals Brain Death/physiopathology Brain Injuries/*physiopathology Humans Hydrocortisone/physiology Neurosecretory Systems/*physiopathology Thyroid Hormones/physiology
Pubmed
Création de la notice
24/01/2008 17:52
Dernière modification de la notice
03/03/2018 13:12
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