Choo Yoon Hee, Kim Moinay, Kim Jae Hyun, Jeon Hanwool, Jung Hee-Won, Ha Eun Jin, Oh Jiwoong, Shim Youngbo, Kim Seung Bin, Jung Han-Gil, Park So Hee, Kim Jung Ook, Kim Junhyung, Kim Hyeseon, Lee Seungjoo
Department of Neurological Surgery and Critical Care Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Department of Neurological Surgery and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2023 Nov;66(6):618-631. doi: 10.3340/jkns.2023.0061. Epub 2023 Jun 12.
The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.
大脑中存在重要的激素调节结构，如下丘脑和垂体，这可能使患有神经系统疾病的患者对危重病相关皮质类固醇功能不全（CIRCI）具有独特的易感性。此外，在各种神经系统疾病中频繁使用类固醇进行治疗可能会导致类固醇功能不全的发生。本摘要旨在强调对于医生而言，在患者护理和管理背景下理解这些关系的重要性。由于大脑在激素调节中的作用，神经系统疾病可能使患者易患CIRCI。在神经系统疾病背景下早期识别CIRCI对于确保及时和适当的干预至关重要。此外，频繁使用类固醇治疗神经系统疾病会导致类固醇功能不全的发生，使临床情况更加复杂。医生必须意识到这些独特的相互作用，并准备好在神经系统疾病背景下评估和管理患有CIRCI和类固醇功能不全的患者。这包括及时诊断、适当的类固醇给药以及仔细监测潜在的不良反应。全面理解神经系统疾病、CIRCI和类固醇功能不全之间的相互作用对于优化这一复杂患者群体的患者护理和治疗结果至关重要。
