[Metabolic changes of plasma norepinephrine levels in acute head injury]

The plasma catecholamine levels have been accepted as an index of sympathetic nervous activity in cardiovascular and neurologic disorders. It is known that the plasma norepinephrine (NE) level is thought to reflect the degree of sympathetic nervous activity. NE is the neurotransmitter released from sympathetic nerve endings. In recent years several studies have suggested the role of biogenic amines in brain and spinal cord trauma. Head injury is almost always associated with systemic changes. Patients with head injury often exhibit cardiovascular abnormalities, hypertension, tachycardia, electrocardiographic abnormalities and acute pulmonary edema which are regarded as signs of increased sympathetic nervous system activity. The present study was undertaken to examine whether the measurement of plasma NE levels is valuable to assess and evaluate clinical status of patients with acute head injuries. Sixty patients with acute head injuries admitted to our Department were studied. Fourty seven patients were male and thirteen patients were female, ages ranged from 2 to 70 years. All patients were diagnosed by CT scan within three hours after head injury. Serial blood samples were also obtained during the first 7 days after head injury. The plasma NE was measured by high performance liquid chromatography. The Glasgow Coma Score (GCS) and the Japan Coma Scale (JCS) were recorded at admission for all patients. Clinical outcome was assessed at the time of discharge according to the Glasgow Outcome Scale. The "good" group consisted of patients with good recovery or moderate disability. The "poor" group consisted of patients with severe disability and persistent vegetative state and the "dead" group.(ABSTRACT TRUNCATED AT 250 WORDS)