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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
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Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...

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Related Experiment Video

Updated: Jul 7, 2026

Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury
09:58

Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury

Published on: November 9, 2018

Glucose control after severe brain injury.

Mauro Oddo1, J Michael Schmidt, Stephan A Mayer

  • 1Division of Neurocritical Care, Columbia University Medical Center, New York, USA. Mauro.Oddo@uphs.upenn.edu

Current Opinion in Clinical Nutrition and Metabolic Care
|February 28, 2008
PubMed
Summary

Intensive insulin therapy may not benefit critically ill neurological patients. Lowering systemic glucose below 6 mmol/l can worsen brain metabolic distress, suggesting a less restrictive glucose target is appropriate.

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Published on: January 11, 2013

Area of Science:

  • Neurocritical care
  • Endocrinology
  • Metabolic disorders

Background:

  • Intensive insulin therapy is established in general critical care.
  • Its role in neurocritical care outcomes remains controversial.
  • Optimal systemic glucose targets after severe brain injury are undefined.

Purpose of the Study:

  • To evaluate the impact of intensive insulin therapy on critically ill neurological patients.
  • To determine the optimal glucose control target in neurocritical care.

Main Methods:

  • Review of recent studies on intensive insulin therapy in neurocritical care.
  • Analysis of brain glucose metabolism and patient outcomes.

Main Results:

  • Critically ill neurological patients exhibit increased brain metabolic demand and reduced cerebral glucose.
  • Systemic glucose reduction below 6 mmol/l with insulin exacerbates brain metabolic distress.
  • Intensive insulin therapy shows no substantial benefit on outcomes in this population.

Conclusions:

  • Optimal glucose control targets for severe brain injury require further investigation.
  • Intensive insulin therapy's impact on brain glucose metabolism and outcomes needs more study.
  • A broader glucose target (6-10 mmol/l) may be more suitable for neurocritical care patients.