title: Hormonal dysfunction in neurocritical patients.
abstract: OBJECTIVE
  Acute brain injury results in widespread systemic endocrine dysfunction and affects how we care for patients. We review the existing literature on incidence, type and duration of endocrine dysfunction with special focus on the pituitary dependent function.
  
  
  RESULTS
  Acute studies document widespread alterations of the hypothalamic-pituitary-adrenal axis, disruption of the anterior hypothalamus related hormones, and alteration of regulation of sodium and fluid balance. Diagnostic testing and therapeutic intervention are outlined in this review. Relative adrenal insufficiency and cerebral salt wasting are the two main forms of endocrine dysfunction in neurocritical care patients.
  
  
  CONCLUSIONS
  Surveillance for endocrine dysfunction and early treatment with hormonal replacement may be life-saving in neurologic critically ill patients.
authors: David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. PVespa@mednet.ucla.edu
authors: Paul M
authors: PM
authors: Vespa
mesh_terms: D000309:Adrenal Insufficiency / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D001926:Brain Death / Q000378:metabolism*; D001930:Brain Injuries / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D016638:Critical Illness; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism; D008297:Male; D010902:Pituitary Gland / Q000378:metabolism* / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000378:metabolism; D012964:Sodium / Q000378:metabolism; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D012964:Sodium