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The Stress Response in Subarachnoid Haemorrhage and Head Injury

  • G. Neil-Dwyer
  • J. M. Cruickshank
  • R. Doshi
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 47)

Abstract

The concept of the stress response—the response to a variety of non-specific damaging agents—has been known for years. There is evidence in some older medical texts that physicians had long suspected the beneficial effect of this response. Hippocrates made mention of this in his writings (Jones 1923) when he stated that “disease caused nature the constitution of the individual to make every effort she could through an exciting cause to restore the original status”. John Hunter in 1794 was the first to put forward the idea of the response to injury as a concept when he wrote “there is a circumstance attending accidental injury which is not belonged to disease namely that the injury alone has in all cases a tendency to produce both the disposition and the means of cure”. Subsequently, this response was described by many eminent workers and it was left to Hans Selye in 1936 who, while working with animals, showed that when they were exposed to a variety of non-specific damaging agents they responded with a discharge of adrenaline and adrenal cortical hormones. The most striking feature of the response was its non-specific nature. Magoun, Ranson, and Hetherington (1937) at around this time, found that stimulating the hypothalamus increased the production of adrenaline and noradrenaline. Their results pointed to the hypothalamus as being involved in the so called “adaptive reaction”. However, in 1944 it became apparent to Selye and, subsequently in 1966 to Raab in particular, that under certain circumstances increased endogenous production during stress or exogenous administration of ACTH, corticosteroids and catecholamines can, in their own right, become the cause of disease, that is, hypertension, diabetes, myocarditis etc. These diseases were well described by Selye as “the diseases of adaption”. Further progress with this concept occurred when Oka (1956) in 1956 was able to show that a marked increase in the free 17 hydroxycorticosteroids after cerebro-vascular accidents indicated a poor prognosis and Kerr Corbett, Prys-Roberts et al. in 1968 demonstrated that overactivity of the sympathetic nervous system in tetanus was a factor in the morbidity of that disease.

Keywords

Head Injury Subarachnoid Haemorrhage Plasma Renin Activity Plasma Cortisol Level Myocardial Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Crane MG, Harris JL (1976) Effect of aging on renin activity and aldosterone excretion. J Lab Clin Med 87: 947–959PubMedGoogle Scholar
  2. Hippocrates. An English translation by Jones WHS (1923) Vol1. William Heineman Ltd, Havard University PressGoogle Scholar
  3. Hoff EC, Kell Jr JF, Hastings N, Sholes DM, Gray EH (1951) Vasomotor, cellular and functional changes produced in the kidney by brain stimulation. J Neurophysiol 14: 317–332PubMedGoogle Scholar
  4. Hunter J (1794) A treatise on the blood, inflammation and gunshot wounds, p 190. Nicol LondonGoogle Scholar
  5. James IM (1972) Electrolyte changes in patients with subarachnoid haemorrhage. Clin Sci 42: 179–187PubMedGoogle Scholar
  6. Kerr JH, Corbett JL, Prys-Roberts C, Crampton-Smith A, Spalding JMK (1968) Involvement of the sympathetic nervous system in tetanus. Lancet ii: 236–241Google Scholar
  7. Magoun HW, Ranson SW, Hetherington A (1937) The liberation of adrenin and sympathin induced by stimulation of the hypothalamus. Am J Physiol 119: 615–622Google Scholar
  8. McLeod AA, Neil-Dwyer G, Meyer CHA, Richardson PL Cruickshank JM, Bartlett J (1982) Cardiac sequelae of acute head injury. Br Heart J 47: 221–226PubMedCrossRefGoogle Scholar
  9. Oka M (1956) Effect of cerebral vascular accidents on the level of 17-hydroxycorticosteroids in plasma. Acta Med Scand 156: 221–226PubMedCrossRefGoogle Scholar
  10. Raab W (1966) Emotional and sensory stress factors in myocardial pathology. Neurogenic and hormonal mechanisms in pathogenesis, therapy and prevention. Am Heart J 72: 583–664CrossRefGoogle Scholar
  11. Selye H (1936) A syndrome produced by diverse nocuous agents. Nature 138: 32–33CrossRefGoogle Scholar
  12. Selye H (1944) Role of hypophysis in the pathogenesis of the disease of adapation. Can Med Assoc J 50: 426–433PubMedGoogle Scholar
  13. Takeuchi J, Yagi S, Nakayama S, Ikeoa T, Uchida E Inque G, Shintani F, Veda H (1960) Experimental studies on the nervous control of the renal circulation—Effect of the electrical stimulation of the diencephalon on the renal circulation. Jpn Heart J 1: 288–299CrossRefGoogle Scholar
  14. Zanchetti A (1976) Hypothalamic control of circulation. The nervous system in arterial hypertension. Julian S, Esler MD (eds) Thomas Ch C, Springfield, IllGoogle Scholar

Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • G. Neil-Dwyer
    • 1
  • J. M. Cruickshank
    • 1
  • R. Doshi
    • 1
  1. 1.Department of NeurosurgeryBrook General HospitalWoolwich, LondonUK

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