Simpatička hiperaktivnost nakon traumatske ozljede mozga

Ana Smajo, Jasminka Peršec

Autonomna disfunkcija nakon traumatske ozljede mozga posljedica je primarne, ali i mogući uzrok sekundarne ozljede mozga. Kliničke manifestacije simpatičke hiperaktivnosti uključuju ponavljajuće epizode tahikardije, hipertenzije, hipertermije, tahipneje i dijaforeze. S obzirom na preklapanje kliničke slike s drugim stanjima te značajan utjecaj na ishod pacijenata, ovaj rad uz prikaz slučaja daje kratki pregled mogućih pristupa liječenju i prepoznavanju ovog sindroma. Cilj rada je skrenuti pažnju na moguće posljedice autonomne disfunkcije na oštećenje krajnjih organa. U radu je prikazan slučaj mlade pacijentice koja je nakon traumatske ozljede glave razvila simptome autonomne disfunkcije koja je dovela do produljenog boravka u jedinici intenzivne medicine, a liječena je prema smjernicama iz dostupne literature te je naposljetku otpuštena u vanjsku ustanovu. Nužna su dodatna istraživanja na ovom području kao i poboljšanje skrbi i razumijevanje složene patofiziologije koja dovodi do autonomnog disbalansa nakon traumatske ozljede mozga.

Autonomic dysfunction following traumatic brain injury is a consequence of the primary injury and is one of the causes of secondary brain injury. Clinical manifestations of sympathetic hyperactivity include recurrent episodes of tachycardia, hypertension, hyperthermia, tachypnea and diaphoresis. Given the overlap of clinical presentation with other conditions and the significant impact on patient outcome, this paper, along with a case report, provides a brief overview of possible approaches to the treatment and recognition of this syndrome. The aim of the paper is to draw attention to the possible consequences of autonomic dysfunction on end-organ damage. This paper presents the case of a young female patient who, after sustaining a traumatic head injury, developed symptoms of autonomic dysfunction that led to an extended stay in the intensive care unit. She was treated according to guidelines from the available literature and was eventually discharged to an external institution. There is a clear need for further research in this area, as well as for improved care and understanding of the complex pathophysiology that leads to autonomic imbalance.