Summary
In six patients with clinical and electroencephalographic signs of brain death, pituitary hormones such as prolactin, human growth hormone (GH), luteinizing hormone (LH), and thyrotrophin (TSH) were measured in blood close to the demonstration of intracranial circulatory arrest by angiography. In addition, pituitary hormone releasing tests and an insulin test were carried out in two patients. The results showed that no patient had a general decrease in hormone levels, according to their biological half life times, which suggests there still was some function in the hypothalamus and pituitary. This was supported by the results of the stimulation tests. It is concluded that in brain death some basal parts of the brain may still be perfused despite the fact that angiography indicates circulatory arrest in these areas.
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Aakvaag, A., Bentdal, O., Quigstad, K., Walstad, P., Rönningen, H., Fonnum, F., Testosterone and testosterone binding globulin (TeBG) in young men during prolonged stress. Internat. J. Andrology1 (1978), 1–11.
Abrams, R. L., Parker, M. L., Blanc, S., Reichlin, S., Daughaday, W. H., Hypothalamic regulation of growth hormone secretion. Endocrinology78 (1966) 605–613.
Antony, G. J., van Wyk, J. J., French, F. S., Weaver, R. P., Dugger, G. S., Timmons, R. L., Newsome, J. F., Influence of pituitary stalk section on growth hormone, insulin and TSH secretion in women with metastatic breast cancer. J. Clin. Endocrinol. Metab.29 (1969), 1238–1250.
Bakke, J. L., Lawrence, N. L., Disappearance rate and distribution of exogenous thyreotropin in the rat. Endocrinology71 (1962), 43–56.
Balslev-Jorgensen, P., Heilbrun, M. P., Boysen, G., Rosenklint, A., Jorgensen, E. O., Cerebral perfusion pressure correlated with regional cerebral blood flow, EEG and aorta/cervical arteriography in patients with severe brain disorders progressing to brain death. Cerebral blood flow and intracranial pressure. Proc. 5th Int. Symp. Roma/Siena 1971, pt 111, Europ. Neurol.8 (1972), 207–212.
Besser, G. M., Orth, D. B., Nicholson, W. E., Byyny, R. L., Abe, K., Woodham, J. P., Dissociation of the disappearance of bioactive and radioimmunoreactive ACTH from plasma in man. J. Clin. Endocrinol. Metab.32 (1971), 595–603.
Bergquist, E., Bergström, K., Angiography in cerebral death. Acta radiologica, Diagnosis12 (1972), 283–288.
Bishop, W., Krulich, L., Fawcett, C. P., McCann, S. M., The effect of median eminence (ME) lesions on plasma levels of FSH, LH and prolactin in the rat (35396). Proc. Soc. Expl. Biol. Med.136 (1971), 925–927.
Brock, M., Schürmann, K., Hadidjimos, A., Cerebral blood flow and cerebral death. Acta Neurochir. (Wien)20 (1969), 195–209.
Bücheler, E., Käufer, C., Düx, A., Zerebrale Angiographie zur Bestimmung des Hirntodes. Fortschr. Röntgenstr.113 (1970), 278–296.
Cameron, D. P., Burger, H. G., Catt, K. J., Doig, A., Metabolic clearance rate of human growth hormone in man. J. Clin. Invest.48 (1969), 1600–1608.
Chen, C. L., Amenomori, Y., Lu, K. H., Voogt, J. L., Meites, J., Neuroendocrinology6 (1970), 220–227.
Egdahl, R. H., Discussion remarks. In: Advances in Neuroendocrinology, pp. 149–155 (Nalbandov, A. V., ed.). Urbana: Univ. of Illinois Press. 1963.
Egdahl, R. H., Adrenal cortical and medullary responses to trauma in dogs with isolated pituitaries. Endocrinology68 (1960), 226–231.
Frohman, L. A., Bernardis, L. L., Growth hormone and insulin levels in weanling rats with ventromedial hypothalamic lesions. Endocrinology82 (1968), 1125–1132.
Ghann, D. S., Cryer, G. L., Feedback control of ACTH secretion by cortisol. In: Brain-Pituitary Adrenal Interrelationships, pp. 197–223 (Brodish A., and Redgate, E. S., eds.). Basel: Karger. 1973.
Gay, V. L., Midgley, A. R., Niswender, G. D., Pattern of gonadotrophin secretion-associated with ovulation. Federation Proc.29 (1970), 1880–1887.
Goodman, J. M., Mishkin, F. S., Dyken, M., Determination of brain death by isotope angiography. J. Amer. med. Ass. (1969), 209–212.
Heiskanen, O., Cerebral circulatory arrest caused by acute increase of intracranial pressure. A clinical and roentgenological study of 25 cases. Acta neurol. scand. Suppl. no7 (1964).
Himsworth, R. L., Carmel, R. W., Frantz, A. G., The location of the chemotransmitter controlling growth hormone secretion during hypoglycemia in primates. Endocrinology91 (1972), 217–226.
Ingvar, D. A., Widen, L., Hjärndöd. Sammenfattning av ett symposium. Läkartidningen69 (1972), 3804–3814.
Kramer, W., Tuyuman, A. J., Acute intracranial hypertention—an experimental investigation. Brain Res.6 (1967), 686–705.
A definition of irreversible coma: Report of the Ad Hoc Committee of the Harvard Medical School to examine the definitions of brain death. JAMA205 (1968), 337–349.
An appraisal of the criteria of cerebral death: A summary statement, a collaborative study. JAMA237 (1976), 982–986.
Lobstein, A., Taupe, J. D., Payeur, G., La fluoroscopie rétinienne dans le diagnostic de la mort cérébrale. Doc. Ophthalmol.26 (1969), 349–358.
Löfstedt, S., von Reis, G., Intracraniella laesioner med bilateralt upphävd kontrastpassage i a. carotis interna (in Swedish). Opusc. med.1 (1956), 199–202.
McCormick, W. F., Halmi, N. S., The hypophysis in patients with coma depĂssé. Amer. J. Clin. Path.54 (1970), 374–384.
Norman, N., Turter, Aa. R., Radioimmunoassay studies with human growth hormone and a pituitary lipid mobilizing factor. Acta Endocr. (Kbh.)58 (1968), 318–338.
Riishede, J., Ethelberg, S., Angiographic appearance in sudden and severe herniation of brain through tentorial incisure. Arch. Neurol. Psychiat.70 (1953), 399–409.
Rutlin, E., Haug, E., Torjesen, P. A., Serum thyrotrophin, prolactin and growth hormone response to TRH during oestrogen treatment. Acta Endocrinol. (Kbh.)84 (1977), 23–35.
Sand, T., Torjesen, P. A., Dextran coated charcoal used in the radioimmunoassay of human pituitary luteinizing hormone. Acta Endocrinol. (Kbh.)73 (1973), 444–454.
Torjesen, P. A., Haug, E., Sand, T., Effect of thyrotrophin-releasing hormone on serum levels of pituitary hormones in men and women. Acta Endocrinol. (Kbh.)73 (1973), 455–464.
Walker, A. E., Diamond, E. L., Moseley, J., The neuropathological findings in irreversible coma. J. Neuropath. Exp. Neurol.34 (1975), 295–323.
Welsch, C. W., Sqiers, M. D., Cassell, E., Chen, C. L., Meites, J., Median eminence lesions and serum prolactin. Influence of ocariectomy and ergocornine. Amer. J. Physiol.221 (1971), 1714–1717.
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Schrader, H., Krogness, K., Aakvaag, A. et al. Changes of pituitary hormones in brain death. Acta neurochir 52, 239–248 (1980). https://doi.org/10.1007/BF01402079
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DOI: https://doi.org/10.1007/BF01402079