Complex diagnostics and prognostic aspects of neuro-endocrinological indicators in combined acute traumatic brain injuries
Abstract
Combined acute traumatic cerebral injury causes direct damage to brain structures and disrupts the work of distant organs, depending on the severity of the traumatic factor. Neuroendocrine disorders are often underdiagnosed in combined acute traumatic brain injuries, which entails the development of complications in both the acute and chronic phases of the disease. The purpose of this study was to analyse the latest scientific evidence on neuro-endocrinological indicators in combined acute traumatic brain injuries to improve patient management protocols and overall survival rates. The research papers from open databases over the past five years have been analysed. It was found that the most common neuro-endocrinological conditions after brain injuries are hypopituitarism, diabetes insipidus, hypothalamus dysfunction, and cognitive disorders. Low blood pressure (both systemic and internal cerebral), anaemia and hypoxia can cause ischemic changes in the central endocrine glands. In the acute phase of the course of combined traumatic brain injuries, signs of deficiency of somatotropic, gonadotropic, and adrenocorticotropic hormones prevail. Vasopressin deficiency in the acute phase is associated with an increased risk of brain oedema, and oxytocin – with the development of neurodegenerative pathologies. Differential diagnosis of neuro-endocrine disorders should be carried out on the basis of anamnestic data and indicators of biochemical and hormonal data of the patient. The obtained data emphasise the importance of timely diagnosis of neuroendocrine disorders along with neurological disorders during the management of patients with traumatic brain injuries can be used both at the stage of primary diagnosis and during the rehabilitation process.