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KMID : 1001920230660060618
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Journal of Korean Neurosurgical Society
2023 Volume.66 No. 6 p.618 ~ p.631
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The Unique Relationship between Neuro-Critical Care and Critical Illness-Related Corticosteroid Insufficiency : Implications for Neurosurgeons in Neuro-Critical Care
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Choo Yoon-Hee
Kim Moi-Nay
Kang So-Yeong
Jeon Han-Wool
Jung Hee-Won
Ha Eun-Jin
Oh Ji-Woong
Shim Young-Bo
Kim Seung-Bin
Jung Han-Gil
Park So-Hee
Kim Jung-Ook
Kim Jun-Hyung
Kim Hye-Seon
Lee Seung-Joo
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Abstract
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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.
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KEYWORD
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Critical illness, Adrenal insufficiency, Intracranial pressure, Traumatic brain injury, Hypotension
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