title: Significance of endocrine studies in the general assessment and prediction of fatal outcome in head injury.
abstract: Serial basal blood glucose, serum insulin, cortisol, growth hormone, glucagon and catecholamine examinations were performed in 81 brain-injured patients. 32 patients with severe injuries of other parts of the body (chest, abdomen, limbs or polytrauma), and 17 patients with non-traumatic acute brain lesions served as double control. In the brain-injured patients there is a close relation between changes of the state of consciousness and those of basal blood glucose levels: the deeper coma the higher and wider is the pathological glucose-level range. Four types of blood-glucose changes could be identified in the background of which different alterations of each hormone level were observed. Fatal outcome could be predicted in a non-diabetic patient in the first days when seeing: 1) Fasting hyperglycaemia above 14 mmol/l; 2) Fluctuating basal blood glucose levels between 5 and 22 mmol/l; 3) Deeply depressed and unchanged basal insulin level; 4) Extremely high cortisol level; 5) Decreased plasma epinephrine level. These changes in the carbohydrate metabolism seen after acute brain lesions are not identical to diabetes mellitus.
authors.affiliation: National Institute of Traumatology, Department of Neurosurgery, Budapest, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Pentelényi
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001930:Brain Injuries / Q000401:mortality* / Q000503:physiopathology; D003128:Coma / Q000097:blood / Q000401:mortality; D004734:Energy Metabolism / Q000502:physiology*; D004837:Epinephrine / Q000097:blood; D005934:Glucagon / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D016489:Head Injuries, Closed / Q000401:mortality* / Q000503:physiopathology; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood; D009104:Multiple Trauma / Q000097:blood / Q000401:mortality; D009638:Norepinephrine / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D001786:Blood Glucose; D006728:Hormones; D007328:Insulin; D013006:Growth Hormone; D005934:Glucagon; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine