gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Characterization of microscopical hypothalamic lesions after severe TBI

Morphologische Charakterisierung hypothalamischer Läsionen nach schwerem SHT

Meeting Abstract

  • corresponding author R.K. Bodics - Institut für Allgemeine Pathologie und Pathologische Anatomie, TU München
  • E. Madler - Institut für Allgemeine Pathologie und Pathologische Anatomie, TU München
  • A. Büttner - Institut für Rechtsmedizin, LMU München
  • H. J. Schneider - Arbeitsgruppe klinische Neuroendokrinologie, MPI für Psychiatrie München
  • G. Piontek - Institut für Allgemeine Pathologie und Pathologische Anatomie, TU München
  • J. Schlegel - Institut für Allgemeine Pathologie und Pathologische Anatomie, TU München

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocP 003

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc258.shtml

Veröffentlicht: 11. April 2007

© 2007 Bodics et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Endocrine changes play an important role in the clinical course of patients after severe traumatic brain injury (TBI). These changes may have prognostic relevance for the long-term outcome of the patients. In previous studies it has been shown that gross alterations e.g. hemorrhages and/or ischemic lesions of the cortico-hypothalamic-pituitary-axis seem to matter, however, since similar clinical symptoms are also found in patients without gross lesions, axonal and neuronal lesions also affect the integrity of the endocrine regulation. In the present study, we examined morphological changes in the hypothalamus in correlation with the endocrine status determined by hormonal levels in the blood and the csf of patient that had died after severe TBI.

Methods: In this study 20 brain samples from autopsies of patients that died after TBI were investigated. Patients with open craniocerebral injury were excluded. Samples from 10 different brain regions, including the anterior and posterior hypothalamus, as well as a sample from the adrenal gland were collected, paraffin-embedded and investigated by conventional histology using H&E- and Bodian-silver-staining and immunohistochemistry. In addition, blood and csf were investigated for pathological altered hormonal concentrations.

Results: Using this approach, we observed DAIs, both by conventional histology and by β-APP-immunoreactivity. In addition activated astrocytes and infiltration of microglial cells were detected by GFAP- and CD68-immunoreactivity, respectively

Conclusions: The demonstration of histological alterations in the hypothalamus without any gross lesions of the cortico-hypothalamic-pitury-axis in our study might indicate axonal injury as an important pathogenetic factor in the development of endocrine failure of patients suffering from severe TBI.