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26 - Neuroendocrine Dysfunction Following Concussion: A Missed Opportunity for Enhancing Recovery?

from Part III - Diagnosis and Management of Concussion

Published online by Cambridge University Press:  22 February 2019

By
Nigel Glynn  and
Amar Agha
Edited by
Jeff Victoroff  and
Erin D. Bigler
Jeff Victoroff
Affiliation:
University of Southern California, Torrance
Erin D. Bigler
Affiliation:
Brigham Young University, Utah
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Summary

There are at least two conceptual frameworks within which to consider the occurrence of neuroendocrine disturbance following typical concussive brain injury (CBI). One: some tissue that orchestrates mammalian endocrine function is lodged in the head. An abrupt rattling blow to the brain might be expected to harm that tissue, or its connections, sometimes. Two: the human stress response is intimately affiliated with and conditioned by neuroendocrine function. As discussed in earlier chapters, the very common occurrence of persistent symptoms more than one year after a single typical CBI is plausibly accounted for, in part, by the risk of a cyclic reaction in which (1) hard-to-measure physical harm to stress management neural tissue (e.g., in the medial temporal lobe), and (2) even harder-to-measure organic change related to psychological stress, might become engaged in a self-reinforcing pattern of cerebral dysfunction. The present chapter, authored by a renowned authority on this subject, explains the state of the art of knowledge regarding neuroendocrine change after CBI. Even more than in the case of sleep disorders, post-CBI endocrine disorders are routinely overlooked. The title of this chapter crystalizes the author’s exhortation: clinicians may often be missing a chance to help.
Type
Chapter
Information
Concussion and Traumatic Encephalopathy
Causes, Diagnosis and Management
 , pp. 767 - 779
Publisher: Cambridge University Press
Print publication year: 2019

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