GLUCOSE METABOLISM IN TRAUMATIC BRAIN INJURY

The present study was designed to evaluate some key metabolic parameters in patients suffering from a traumatic brain contusion with coma. This evaluation was carried out before and during an intravenous glucose tolerance test (iv – GTT) in 6 male patients paired with normal controls Four patients presented a fasting hyperglycaemia and a low K rate of glucose disappearance but the basal level of insulin was normal or high and the insulin response to the glucose load was not significantly impaired. The basal level of plasma growth hormone (HGH) was usually normal but it increased paradoxically during the iv – GTT; 2 patients had a striking hyper-response. Plasma cortisol levels were always elevated. On the other hand no gross or systematic anomaly in the regulation of plasma free fatty acids, acetoacetate and amino nitrogen was detected. The paradoxical HGH response was the only finding which could be specifically attributed to the central neural lesions.