title: Early stage alterations of catecholamine and adrenocorticotropic hormone levels in posttraumatic acute diffuse brain swelling.
abstract: Posttraumatic acute diffuse brain swelling (PADBS) is characterized by serious brain bulk enlargement rapidly following trauma and is a major cause of elevated intracranial pressure and thus mortality. The pathogenesis of PADBS is not clearly understood, and the early stage alterations of catecholamine (CA) and adrenocorticotropic hormone (ACTH) levels in PADBS also remain largely unknown. The objective of this study was to investigate CA and ACTH levels in the patients with PADBS in the early stage and discuss the possible roles CA and ACTH in the pathogenesis of PADBS. It is a cross-sectional study. A group of patients with PADBS (n=10) was compared with a group of patients with severe brain injury (SBI) (n=33). A control group of healthy adults (n=25) was also included. Blood samples were obtained to measure levels of epinephrine (EPI), norepinephrine (NE), dopamine (DA), and ACTH as soon as the patients arrived at the neurosurgery department, which was done within 4h after trauma. Both SBI and PADBS groups of patients had higher levels of EPI, NE, DA, and ACTH than the control group. The PADBS group had significantly higher levels of EPI, NE, and ACTH than the SBI group. CA and ACTH levels are significantly increased in early stage PADBS. These results imply that CA and ACTH may play important roles in the pathogenesis of PADBS. To eliminate the effects of CA and ACTH at the early stage, and thereby protect the hypothalamus and brain stem, might be critical measures for treating patients with PADBS.
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, Shantou University Medical College, 57 Changping Road, Shantou, Guangdong 515041, China.
authors.forename: Weiqiang
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Microbiology and Immunology, Key Immunopathology Laboratory of Guangdong Province, Shantou University Medical College, 22 Xinling Road, Shantou, Guangdong 515041, China.
authors.forename: Jiangtao
authors.initials: J
authors.lastname: Sheng
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, Shantou University Medical College, 57 Changping Road, Shantou, Guangdong 515041, China.
authors.forename: Guoyi
authors.initials: G
authors.lastname: Peng
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital, Shantou University Medical College, 57 Changping Road, Shantou, Guangdong 515041, China.
authors.forename: Jinhua
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Fuzhou General Hospital, Xiamen University Medical College, Fuzhou 350025, China. Electronic address: wshsen@xmu.edu.cn.
authors.forename: Shousen
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Microbiology and Immunology, Key Immunopathology Laboratory of Guangdong Province, Shantou University Medical College, 22 Xinling Road, Shantou, Guangdong 515041, China. Electronic address: ksli@stu.edu.cn.
authors.forename: Kangsheng
authors.initials: K
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001929:Brain Edema / Q000097:blood*; D001930:Brain Injuries / Q000097:blood*; D002395:Catecholamines / Q000097:blood*; D003430:Cross-Sectional Studies; D004298:Dopamine / Q000097:blood; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D009638:Norepinephrine / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002395:Catecholamines; D000324:Adrenocorticotropic Hormone; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine
keywords: Adrenocorticotropic hormone; Catecholamines; Critical care; Dopamine; Epinephrine; Norepinephrine; Posttraumatic acute brain swelling