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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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The neuropathology of traumatic brain injury
McKee, A. C., & Daneshvar, D. H. (2015) · Handbook of clinical neurology · doi:10.1016/b978-0-444-52892-6.00004-0 · Cited by 899
McKee, A. C., Daneshvar, D. H., Alvarez, V. E., & Stein, T. D. (2014) · Acta Neuropathologica · doi:10.1007/s00401-013-1230-6 · Cited by 422
“Although the definition of SIS is controversial and some investigators have challenged its existence [123], SIS is thought to result from abrupt posttraumatic loss of cerebral blood flow autoregulation and catecholamine release that create a rapid increase in intracranial blood volume and catastrophic cerebral edema […”
BackgroundThe Influence of Hyperglycemia on Neurological Outcome in Patients with Severe Head Injury
Rovlias, A., & Kotsou, S. (2000) · Neurosurgery · doi:10.1097/00006123-200002000-00015 · Cited by 419
Hyperglycemia and neurological outcome in patients with head injury
Lam, A. M., Winn, H. R., Cullen, B. F., & Sundling, N. (1991) · Journal of neurosurgery · doi:10.3171/jns.1991.75.4.0545 · Cited by 347
Cellular infiltration in traumatic brain injury
Alam, A., Thelin, E. P., Tajsic, T., Khan, D. Z., Khellaf, A., Patani, R., & Helmy, A. E. (2020) · Journal of Neuroinflammation · doi:10.1186/s12974-020-02005-x · Cited by 309
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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