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Urinary free cortisol excretion shortly after ischaemic stroke
1Department of Internal Medicine, Umeå University Hospital, Sweden.
Journal of Internal Medicine
|August 1, 1990
Summary
Acute ischemic stroke elevates cortisol axis activity and catecholamine excretion. Higher cortisol levels correlate with poorer functional outcomes and stroke severity, impacting organ function.
Area of Science:
- Neuroendocrinology
- Stroke Medicine
- Physiology
Background:
- The stress response involves the hypothalamic-pituitary-adrenal (HPA) axis, including cortisol production.
- Catecholamines are also released during stress and can affect physiological functions.
- The impact of acute ischemic stroke on these systems is not fully understood.
Purpose of the Study:
- To investigate the activity of the cortisol axis and catecholamine excretion in patients with acute ischemic stroke.
- To determine the relationship between these neuroendocrine markers and stroke severity or functional outcome.
Main Methods:
- Studied 20 patients within one week of acute ischemic stroke.
- Measured urine free cortisol and plasma cortisol levels post-dexamethasone.
- Assessed catecholamine excretion and correlated it with clinical parameters like limb paresis and disorientation.
Main Results:
- Stroke patients exhibited significantly higher urine and plasma cortisol levels compared to healthy controls.
- Catecholamine excretion correlated with urine cortisol concentration and limb paresis.
- Higher urine cortisol levels were associated with limb paresis, disorientation, and elevated body temperature.
Conclusions:
- Acute ischemic stroke is linked to increased activity of the cortisol axis.
- Elevated cortisol excretion predicts a poorer functional outcome post-stroke.
- This heightened neuroendocrine response may negatively affect organ function.