Distant Organ Damage in Acute Brain Injury

Abstract

Acute brain injuries pose a great threat to global health, having significant impact on mortality and disability. Patients with acute brain injury may develop distant organ failure, even if no systemic diseases or infection is present. The severity of non-neurologic organs' dysfunction depends on the extremity of the insult to the brain. In this comprehensive review we sought to describe the organ-related consequences of acute brain injuries. The clinician should always be aware of the interplay between central nervous system and non-neurological organs, that is constantly present. Cerebral injury is not only a brain disease, but also affects the body as whole, and thus requires holistic therapeutical approach.

Keywords: acute brain injury; critical illness; organ dysfunction; systemic response.

Figure 1

Common pathomechanism of distant organ damage in acute brain conditions. Inflammation, increased sympathetic tone and catecholamine surge in response to brain injury may affect different organs simultaneously, leading to their failure.

Figure 2

Pathological pathways of heart injury in acute brain damage patients. Catecholamine surge, inflammation and HPA axis imbalance are the leading causes of heart dysfunction following brain injury, which may manifest in Tako-tsubo cardiomyopathy.