Complex diagnostics and prognostic aspects of neuro-endocrinological parameters in acute combined traumatic brain injuries

Abstract

It is known that acute combined traumatic brain injury causes not only direct damage to brain structures, but also disrupts the functioning of distant organs, depending on the severity of the traumatic factor. Neuroendocrine disorders are often underdiagnosed in the clinic of acute combined traumatic brain injuries, which entails the development of complications in both the acute and chronic phases of the disease. The purpose of this work was to analyze the latest scientific evidence regarding neuro-endocrinological parameters in acute combined traumatic brain injuries to improve patient management protocols and improve overall survival rates. An analysis of scientific works from open databases over the past five years was carried out. It was found that the most common neuro-endocrinological conditions after traumatic brain injury are hypopituitism, diabetes insipidus, hypothalamic dysfunction and cognitive impairment. Low blood pressure (both systemic and intracerebral), anemia and hypoxia can cause ischemic changes in the central endocrine glands. In the acute phase of acute combined traumatic brain injuries, signs of deficiency of somatotropic, gonadotropic and adrenocorticotropic hormones predominate. Vasopressin deficiency in the acute phase is associated with an increased risk of developing cerebral edema, and oxytocin deficiency is associated with the development of neurodegenerative pathologies. Differential diagnosis of neuroendocrine disorders should be carried out on the basis of anamnestic data and indicators of the patient’s biochemical and hormonal data. The data obtained emphasize the importance of timely diagnosis of neuroendocrine disorders along with neurological ones during the management of patients with traumatic brain injuries; they can be used both at the stage of primary diagnosis and during the rehabilitation process