1. The function of the hypothalamo-pituitary axis in brain dead patients
- Author
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Kazunori Arita, Tohru Uozumi, Shuichi Oki, Minako Ohtani, Kaoru Kurisu, and Mikami T
- Subjects
Adult ,Male ,Brain Death ,Hypothalamo-Hypophyseal System ,Thyroid Hormones ,medicine.medical_specialty ,Pituitary gland ,Adolescent ,Pituitary Function Tests ,Thyrotropin ,Hemodynamics ,Adrenocorticotropic Hormone ,Hypothalamic Hormones ,Anterior pituitary ,Pituitary Hormones, Anterior ,Reference Values ,Internal medicine ,medicine ,Humans ,Child ,Aged ,Aged, 80 and over ,business.industry ,Blood flow ,Luteinizing Hormone ,Middle Aged ,Prolactin ,Endocrinology ,medicine.anatomical_structure ,Cerebral blood flow ,Hypothalamus ,Growth Hormone ,Female ,Surgery ,Neurology (clinical) ,Follicle Stimulating Hormone ,business ,Hormone - Abstract
In order to find out the function of the hypothalamo-pituitary axis in brain dead patients, pituitary and hypothalamic hormone concentrations were measured and several anterior pituitary releasing tests were carried out in 39 brain dead patients. In addition, cerebral blood flow measurements were simultaneously performed. In almost all cases, the blood concentration of pituitary and hypothalamic hormones were above the sensitivity of the assay. Anterior pituitary releasing tests indicated that efficient functions of the hypothalamus were severely suppressed, while the normal secretory mechanism of the anterior pituitary was partially preserved in brain dead patients. Histological changes of hypothalamic neurons varied from barely detectable ghost cells to nearly normal cells even in the same case. Although, the remaining circulation seemed not to be sufficient enough to maintain integrated hypothalamo-pituitary function, as shown by the examinations of cerebral blood flow, the presence of hypothalamic hormones in the systemic circulation suggests that these hormones were released and carried from the hypothalamus by minimal flow which is preserved even after the diagnosis of brain death.
- Published
- 1993