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The Unique Relationship between Neuro-Critical Care and Critical Illness-Related Corticosteroid Insufficiency : Implications for Neurosurgeons in Neuro-Critical Care

  • Yoon Hee Choo (Department of Neurological Surgery and Critical Care Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Moinay Kim (Department of Neurological Surgery and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jae Hyun Kim (Department of Neurological Surgery and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hanwool Jeon (Department of Neurological Surgery and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hee-Won Jung (Department of Neurological Surgery and Critical Care Medicine, Chungnam National University Hospital) ;
  • Eun Jin Ha (Department of Neurological Surgery and Critical Care Medicine, Seoul National University Hospital) ;
  • Jiwoong Oh (Department of Neurological Surgery and Critical Care Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Youngbo Shim (Department of Neurological Surgery and Critical Care Medicine, Kangbuk Samsung Hospital) ;
  • Seung Bin Kim (Department of Neurological Surgery and Critical Care Medicine, Seoul National University Boramae Medical Center) ;
  • Han-Gil Jung (Department of Neurological Surgery and Critical Care Medicine, Seoul National University Bundang Hospital) ;
  • So Hee Park (Department of Neurological Surgery and Critical Care Medicine, Yeungnam University Medical Center) ;
  • Jung Ook Kim (Department of Neurological Surgery and Critical Care Medicine, Gachon University Gil Hospital Regional Trauma Center) ;
  • Junhyung Kim (Department of Neurological Surgery and Critical Care Medicine, Gangnam Severance Hospital) ;
  • Hyeseon Kim (Department of Neurological Surgery and Critical Care Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Seungjoo Lee (Department of Neurological Surgery and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2023.03.23
  • Accepted : 2022.06.07
  • Published : 2023.11.01

Abstract

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.

Keywords

Acknowledgement

This research was supported by a grant from the Korean Government Ministr y of Science and ICT (MSIT) (2022R1A2C2011941), and Asan Institute for Life Sciences, Asan Medical Center - 2023IP0040, 2023IP0037, 2023IP0111 (Seoul, Republic of Korea), and Digital Healthcare Research Grant through the Seokchun Caritas Foundation (SCY2107P).

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