Evaluation of the Relationship of Intracranial Pressure with the Levels of Hypothalamic-Pituitary-Gonadal Axis Hormones on Prognosis in Severe Brain Injury

2017 
Objective: Head traumas have an important place among all traumatic injuries and it is an important public health problem worldwide. Novel methods predicting prognosis may contribute to a decrease in the mortality and morbidity rates. Materials and Methods: Continuous intracranial pressure (ICP) measurements, initial cerebral computed tomography (CT) and measurement of the hypothalamic-pituitary-gonadal (HPG) axis hormones between the 0th and 4th days were performed in 15 adult male patients with severe head trauma. The relationship of these parameters with the short-term results of the patients on the 15th day was evaluated. Additionally, provocation tests were carried out to evaluate the HPG axis function. Results: High ICP and compression of basal cisterna increased mortality and they were found to affect prognosis (p=0.009 and p=0.033, respectively) No statistically significant association was found between midline shift and prognosis. No relationship was found between mortality and mean basal hormone values on the 0th day and between the 1st and 4th days. Conclusion: ICP measurement values and the presence of compression of basal cistern on the initial brain CT can be used to predict the prognosis in severe head injury but there is no significant relationship between hypophyseal hormone values and prognosis.
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