Electrolyte and endocrine disturbances

Acute brain injury triggers a complex cascade of metabolic and neurohumoral responses that leads to a variety of derangements in electrolyte and endocrine homeostasis. The resultant clinical picture is a rapidly evolving interplay between failed homeostatic mechanisms, physiological compensatory responses, and intracranial and systemic complications. This chapter reviews the pathophysiology, treatment, and outcome effects of commonly encountered electrolyte and endocrine abnormalities encountered in critically ill neurological patients. In particular, the pathophysiology, diagnosis, management, and outcome effects of acute brain injury-related disorders of glucose and sodium homeostasis, and endocrine dysfunction, will be reviewed. Where available, consensus guidance for diagnosis and management are presented.