Adrenocorticotropic Hormone and β-endorphin Concentration As A prognostic Factor In Patients With Subarachnoid Hemorrhage Due to Aneurysmal Rupture— Seong Park 2022
Acute stress results in the release of the pituitary neuro-peptides adrenocorticotropic hormone (ACTH) and -endorphin. Studying endogenous neuropeptides, such as ACTH and -endorphin, allowed us to understand why the prognosis of patients with subarachnoid hemorrhages (SAH) brought on by aneurysmal rupture is not always dependent on the Hunt-Hess grading system (HHS) and delta-National Institutes of Health Stroke Scale (NIHSS). We examined blood samples taken from patients with SAH (SAH group; n=37) and controls (control group; n=37) who had unruptured intracranial aneurysms. Before beginning any surgery or administering any chemicals, blood was sampled. Using the delta-NIHSS and HHS, the results of ACTH and -endorphin measures were compared. Descriptive statistics, independent samples t-tests, and Pearson's correlations were used to examine the data.13 patients with low delta-NIHSS and five with high delta-NIHSS out of the 18 patients with low-grade HHS. Five of the 19 patients with high-grade HHS had a delta-NIHSS of less than 14. Five individuals with high-grade HHS and high delta-NIHSS had high levels of ACTH (497.3 pg/mL). 13 patients with mild-grade HHS and low delta-NIHSS had high -endorphin concentrations (159.7 pg/mL). Increased ACTH secretion in response to bleeding stress may worsen neurological status, as suggested by high ACTH levels in individuals with extensive bleeding and poor neurological status. In contrast to ACTH, high levels of -endorphin in patients with low-grade HHS suggested that other factors were involved in predicting fair outcomes associated with low delta-NIHSS.
Park, Geo-Seong et al. “Adrenocorticotropic hormone and β-endorphin concentration as a prognostic factor in patients with subarachnoid hemorrhage due to aneurysmal rupture.” Journal of cerebrovascular and endovascular neurosurgery vol. 24,2 (2022): 113-120. doi:10.7461/jcen.2021.E2021.08.003
