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Circulating Catecholamines and Sympathetic Activity after Head Injury
Abstract
Plasma norepinephrine (NE) and dopamine beta-hydroxylase (DBH) levels were measured during the first 7 days after head injury in 48 patients. Blood pressure, pulse, temperature, and Glasgow coma score (GCS) were recorded at the time of sampling for each patient, and the relationships of these to NE and DBH were examined. In patients with multiple trauma, NE levels were usually elevated, regardless of the GCS. In patients with head injury alone, however, NE was proportional to GCS. Alert patients after a brief loss of consciousness (GCS, 14) had normal NE levels. Those in coma had levels as high as 7 times normal. Blood pressure, pulse, and temperature were found to be elevated proportionally to elevations in plasma NE in patients with head injury. The finding of elevated plasma NE in patients with severe head injury raises the possibility of adverse effects of sympathetic hyperactivity in patients with severe head injury, including hypermetabolism, cardiovascular abnormalities, and direct effects of catecholamines on the damaged central nervous system.
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“SIS is thought to result from abrupt post-traumatic loss of cerebral blood flow autoregulation and catecholamine release that create a rapid increase in intracranial blood volume and catastrophic cerebral edema [32, 105].”
From The neuropathology of sport (2014) · cites this paper as [32]
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Traumatic brain injury and β-blockers
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Russo, R., & O’Flaherty, S. (2000) · Journal of Paediatrics and Child Health · doi:10.1046/j.1440-1754.2000.00485.x · Cited by 65
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“It is well established that head-injured patients develop an adverse hyperadrenergic state with increase in proinflammatory sympathetic discharge and catecholamine release (42, 59).”
BackgroundHepatic Drug Metabolism in Critical Illness
McKindley, D. S., Hanes, S. D., & Boucher, B. A. (1998) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/j.1875-9114.1998.tb03898.x · Cited by 53
β-Blocker Exposure in Patients With Severe Traumatic Brain Injury (TBI) and Cardiac Uncoupling
Riordan, W. P., Cotton, B. A., Norris, P. R., et al. (2007) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e3181271c34 · Cited by 52
Raj, R., Mikkonen, E. D., Siironen, J. O., Hernesniemi, J. A., Lappalainen, J., & Skrifvars, M. B. (2015) · Journal of neurosurgery · doi:10.3171/2015.4.jns141746 · Cited by 51
Palmieri, M., Frati, A., Santoro, A., Frati, P., Fineschi, V., & Pesce, A. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms221910865 · Cited by 49
“Changes in glycemia levels in severe TBI are related to the increased blood levels of catecholamines caused by the sympathetic hyperactivity after the traumatic injury [19,20].”
BackgroundTraumatic brain injury stimulates hippocampal catechol-O-methyl transferase expression in microglia
Redell, J. B., & Dash, P. K. (2006) · Neuroscience Letters · doi:10.1016/j.neulet.2006.11.060 · Cited by 49
“In the present study, the selection of COMT for a more detailed analysis was guided by a number of previous studies that have implicated catecholamine signaling in the behavioral sequelae of TBI [4,20,21].”
BackgroundCatecholamine response to a gradual increase of intracranial pressure
van Loon, J., Shivalkar, B., Plets, C., et al. (1993) · Journal of neurosurgery · doi:10.3171/jns.1993.79.5.0705 · Cited by 48
Marklund, N. (2017) · Frontiers in Neurology · doi:10.3389/fneur.2017.00540 · Cited by 46
O’Meara, A. I., Sequeira, J., & Ferguson, N. M. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00118 · Cited by 47
The Metabolic Response to Brain Injury
Ott, L. G., Young, B., & McClain, C. J. (1987) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607187011005488 · Cited by 46
The neuroendocrinology of physical injury
Barton, R. N. (1987) · Baillière s Clinical Endocrinology and Metabolism · doi:10.1016/s0950-351x(87)80067-8 · Cited by 46
Incidence, Risk Factors, and Outcomes for Atrial Arrhythmias in Trauma Patients
Hadjizacharia, P., O’Keeffe, T., Brown, C., et al. (2011) · The American Surgeon · doi:10.1177/000313481107700526 · Cited by 45
β-Blockers for traumatic brain injury: A systematic review and meta-analysis
Ding, H., Liao, L., Zheng, X., Wang, Q., Liu, Z., Xu, G., Li, X., & Liu, L. (2021) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000003094 · Cited by 46
Severe traumatic brain injury management and clinical outcome using the Lund concept
Koskinen, L., Olivecrona, M., & Grände, P. O. (2014) · Neuroscience · doi:10.1016/j.neuroscience.2014.06.039 · Cited by 44
“Head-injured patients are severely stressed with a markedly raised concentration of catecholamines in plasma (Clifton et al., 1981).”
BackgroundCardiac Reactive Oxygen Species After Traumatic Brain Injury
Larson, B., Stockwell, D. W., Boas, S., Andrews, T. J., Wellman, G. C., Lockette, W. E., & Freeman, K. (2011) · Journal of Surgical Research · doi:10.1016/j.jss.2011.09.056 · Cited by 43
Metadata
- Authors
- Clifton, G. L., Ziegler, M. G., & Grossman, R. G.
- Affiliations
- University of California San Diego (US)
- Venue
- Neurosurgery
- Published
- 1981-01
- Volume
- 8
- Issue
- 1
- Pages
- 10-14
- ISSN
- 0148-396X (ISSN-L)
- OpenAlex
- W1988160703
- Cited by
- 296
- References
- 0
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 8 · 2023: 3 · 2022: 2 · 2021: 8 · 2020: 8 · 2019: 6 · 2018: 6 · 2017: 20 · 2016: 16 · 2015: 14 · 2014: 8 · 2013: 2 · 2012: 6
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurosurgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- traumatic brain injury, norepinephrine, dopamine beta-hydroxylase, circulating catecholamines, sympathetic hyperactivity, Glasgow coma score, coma, polytrauma, blood pressure, pulses, body temperature, hypermetabolism, cardiovascular anomalies
- MeSH terms
- Blood Pressure, Brain Injuries, Catecholamines, Coma, Dopamine beta-Hydroxylase, Humans, Norepinephrine, Sympathetic Nervous System
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