TY - CHAP
T1 - Autonomic dysfunction syndromes after acute brain injury
AU - Takahashi, Courtney
AU - Hinson, Holly E.
AU - Baguley, Ian J.
N1 - Publisher Copyright:
© 2015 Elsevier B.V.
PY - 2015
Y1 - 2015
N2 - The central autonomic nervous system (CAN) is a multifaceted, richly connected neural network incorporating the hypothalamus, its descending tracts through the brainstem, the insular cortex and down into the spinal cord. All levels of the CAN are susceptible to injury following traumatic brain injury (TBI), whether from focal or diffuse injury. Focal injuries would be expected to produce localized damage to CAN control centers, whereas the effects of diffuse injuries are presumed to be more diverse and/or widely distributed.As the combination of focal and diffuse injury following TBI can vary widely from one individual to the next, the impact of focal injuries is best understood with reference to the focal ischemic stroke literature. Subarachnoid hemorrhage (SAH), a common complication following TBI, also has predictable effects on autonomic control that can be understood with reference to spontaneous SAH literature. Finally, paroxysmal sympathetic hyperactivity (PSH), a syndrome incorporating episodes of heightened sympathetic drive and motor overactivity following minor stimulation, is discussed as an example of what happens when central inhibitory control of spinal cord autonomics is impaired.
AB - The central autonomic nervous system (CAN) is a multifaceted, richly connected neural network incorporating the hypothalamus, its descending tracts through the brainstem, the insular cortex and down into the spinal cord. All levels of the CAN are susceptible to injury following traumatic brain injury (TBI), whether from focal or diffuse injury. Focal injuries would be expected to produce localized damage to CAN control centers, whereas the effects of diffuse injuries are presumed to be more diverse and/or widely distributed.As the combination of focal and diffuse injury following TBI can vary widely from one individual to the next, the impact of focal injuries is best understood with reference to the focal ischemic stroke literature. Subarachnoid hemorrhage (SAH), a common complication following TBI, also has predictable effects on autonomic control that can be understood with reference to spontaneous SAH literature. Finally, paroxysmal sympathetic hyperactivity (PSH), a syndrome incorporating episodes of heightened sympathetic drive and motor overactivity following minor stimulation, is discussed as an example of what happens when central inhibitory control of spinal cord autonomics is impaired.
KW - Central autonomic network
KW - Hyperadrenergic crisis
KW - Paroxysmal sympathetic hyperactivity
KW - Stroke
KW - Subarachnoid hemorrhage
KW - Traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=84924963237&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924963237&partnerID=8YFLogxK
U2 - 10.1016/B978-0-444-63521-1.00034-0
DO - 10.1016/B978-0-444-63521-1.00034-0
M3 - Chapter
C2 - 25701906
AN - SCOPUS:84924963237
T3 - Handbook of Clinical Neurology
SP - 539
EP - 551
BT - Handbook of Clinical Neurology
PB - Elsevier B.V.
ER -