Hormonal Changes in Intracranial Hemorrhage

  • Rajendra Shrestha department of Neurosurgery,NAMS, Bir Hospital/ National Trauma Centre
  • Reeka Pradhan Paropkar maternity and women’s Hospital, Thapathali, Nepal
  • Mahesh Pradhan Department of Surgery, Sumeru Hospital, Nepal
  • Chao You Department of Neurosurgery, West China Hospital, Sichuan University, China.
Keywords: ACTH; ICH; lymphocyte ICH; thyroid hormone.

Abstract

Introduction: The purpose of this study was to investigate the changes of serum ACTH and Thyroid hormone level in the acute phase of ICH.

Methods: Sixty patients with spontaneous ICH were assessed regarding hormonal changes by measuring ACTH and Thyroid hormone level. The relationships of hormone concentrations to clinical and radiological parameters were evaluated at hospital admission (t0), 5 days (t1) and 10 days (t2). The results were statistically analyzed.

Results: ACTH, TSH, Thyroxine, and free Thyroxine were not significantly different among the three time periods (P > 0.05), while Triiodothyronine (T3) and free Triiodothyronine (FT3) were significantly different (P < 0.05). T3 and FT3 were not significantly different among patients with hemorrhage of different locations (P>0.05). There were significant negative correlations between T3 and FT3 with volume of ICH (r=-0.63 and r=-0.25) and there were positive correlations between T3 and FT3 with GCS (r=0.63 and r=0.37) respectively on admission day (p <0.05).

Conclusions: Hormonal secretion patterns is associated with the severity of ICH. This is an important index to evaluate the disease severity and prognosis.

Keywords: ACTH; ICH; lymphocyte ICH; Thyroid hormone.

References

1. Kase CS, Caplan LR. Intracerebral Hemorrhage. Newton, MA: Butterworth-Heinemann; 1994.
2. Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344:1450–60.
3. Reincke M, Allolio B, Wurth G, Winkelmann W. The hypothalamic–pituitary–adrenal axis in critically ill patients: response to CRH and dexamethasone. J ClinEndocrinolMetab 1993;77:151-6.
4. SiesjöBK&Siesjö P. Mechanisms of secondary brain injury. Eur J Anaesthesiol 1996; 13:24768.
5. Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M, Khoury J. The ABCs of measuring intracerebral hemorrhage volumes. Stroke. 1996;27:1304–5.
6. Huttner HB, Steiner T, Hartmann M, Ko¨hrmann M, Juettler E, Mueller S, Wikner J, Meyding-Lamade U, Schramm P, Schwab S, Schellinger PD. Comparison of ABC/2 estimation technique to computer-assisted planimetric analysis in warfarin-related intracerebral parenchymal hemorrhage. Stroke. 2006;37:404–8.
7. Xi G, Keep RF, Hoff JT. Mechanisms of brain injury after intracerebral haemorrhage. Lancet Neurol. 2006;5:53–63.
8. Aronowski J, Hall CE. New horizons for primary intracerebral hemorrhage treatment: Experience from preclinical studies. Neurol Res. 2005;27:268–79.
9. Gong C, Hoff JT, Keep RF. Acute inflammatory reaction following experimental intracerebral hemorrhage in rat. Brain Res. 2000;871:57–65.
10. Wang J, Dore S. Inflammation after intracerebral hemorrhage. J Cereb Blood Flow Metab. 2007;27:894–908.
11. Huang FP, Xi G, Keep RF, Hua Y, Nemoianu A, Hoff JT. Brain edema after experimental intracerebral hemorrhage: Role of hemoglobin degradation products. J Neurosurg. 2002;96:287– 93
12. Wang X, Mori T, Sumii T, Lo EH. Hemoglobin-induced cytotoxicity in rat cerebral cortical neurons: Caspase activation and oxidative stress. Stroke. 2002;33:1882–88.
13. Zhao X, Sun G, Zhang J, Strong R, Song W, Gonzales N, et al. Hematoma resolution as a target for intracerebral hemorrhage treatment: Role for peroxisome proliferator-activated receptor gamma in microglia/macrophages. Ann Neurol. 2007;61:352–62
14. ElvioS,Stefano B, Amir E, et al. Low triiodothyronine (T3) state: a predictor of outcome in repiratory failure? Results of a clinical pilot study [J]. Endocrinology,2004;151(5):557-60.
15. Elovic EP ,Glenn MB. Anterior pituitary dyfunction after traumatic brain injury [J]. J Head Trauma Rehabil, 2004;19(2):184-7.
16. Chrousos GP. The hypothalamic-pituitary-adrenal axis and immune-mediated inflammation. N Engl J Med 1995;332:1351-62.
17. Vaughan GM, Becker RA, Allen JP, Goodwin CW, Pruitt BA, Mason AD. Cortisol and corticotropin in burned patients. J Trauma 1982;22:263-72.
18. Brent GA, Hershman JM, Braunstein GD. Patients with severe nonthyroidal illness and serum thyrotropin concentrations in the hypothyroid range. Am J Med 1986;81: 463-6
19. Wastofsky L, Burman KD. Alterations in thyroid function in patients with systemic illness: the "euthyroid sick syndrome." Endocr Rev 1982;3:164-217
20. Farsky SP, Sannomiya P, Garcia-Leme J. Secreted glucocorticoids regulate leukocyte–endothelial interactions in inflammation. A direct vital microscopic study. J Leukoc Biol 1995;57:37986.
Published
2017-03-31
How to Cite
Shrestha, R., Pradhan, R., Pradhan, M., & You, C. (2017). Hormonal Changes in Intracranial Hemorrhage. Journal of Nepal Medical Association, 56(205), 163-167. https://doi.org/10.31729/jnma.3026
Section
Original Article