Skip to main content

Advertisement

SpringerLink
Log in

Alteration in brain natriuretic peptide (BNP) plasma concentration following severe traumatic brain injury

  • Clinical Article
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Background. Brain natriuretic peptide (BNP) is a potent natriuretic and vasodilator factor which, by its systemic effects, can decrease cerebral blood flow (CBF). In aneurysmal subarchnoid hemorrhage (aSAH), BNP plasma concentrations were found to be associated with hyponatremia and were progressively elevated in patients who eventually developed delayed ischemic deficit secondary to vasospasm. The purpose of the present study was to evaluate trends in BNP plasma concentrations during the acute phase following severe (traumatic brain injury) TBI.

Methods. BNP plasma concentration was evaluated in 30 patients with severe isolated head injury (GCS < 8 on admission) in four time periods after the injury (period 1: days 1–2; period 2: days 4–5; period 3: days 7–8; period 4: days 10–11). All patients were monitored for ICP during the first week after the injury.

Findings. The initial BNP plasma concentrations (42 ± 36.9 pg/ml) were 7.3 fold (p < 0.01) higher in TBI patients as compared to the control group (5.78 ± 1.90 pg/ml). BNP plasma concentrations were progressively elevated through days 7–8 after the injury in patients with diffused SAH as compared to patients with mild or no SAH (p < 0.001) and in patients with elevated ICP as compared to patients without elevated ICP (p < 0.001). Furthermore, trends in BNP plasma concentrations were significantly and positively associated with poor outcome.

Interpretation. BNP plasma concentrations are elevated shortly after head injury and are continuously elevated during the acute phase in patients with more extensive SAH and in those with elevated ICP, and correlate with poor outcomes. Further studies should be undertaken to evaluate the role of BNP in TBI pathophysiology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • E Berendes M Walter P Cullen et al. (1997) ArticleTitleSecretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage Lancet 349 245–249 Occurrence Handle10.1016/S0140-6736(96)08093-2 Occurrence Handle1:STN:280:ByiC28jit1c%3D Occurrence Handle9014912

    Article  CAS  PubMed  Google Scholar 

  • PC Donati-Genet JM Dubuis E Girardin et al. (2001) ArticleTitleAcute symptomatic hyponatremia and cerebral salt wasting after head injury: an important clinical entity J Pediuter Surg 36 1094–1097 Occurrence Handle1:STN:280:DC%2BD3MznsVymsg%3D%3D

    CAS  Google Scholar 

  • CM Fisher JP Kistler JM Davis (1980) ArticleTitleRelation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning Neurosurgery 6 1–9 Occurrence Handle1:STN:280:Bi%2BC38%2FpslY%3D Occurrence Handle7354892

    CAS  PubMed  Google Scholar 

  • S Fukui H Katoh N Tsuzuki S Ishihara N Otani H Ooigawa T Toyooka A Ohnuki T Miyazawa H Nawashiro K Shima (2004) ArticleTitleFocal brain edema and natriuretic peptides in patients with subarachnoid hemorrhage J Clin Neurosci 11 507–511 Occurrence Handle1:CAS:528:DC%2BD2cXks1eksLs%3D Occurrence Handle15177394

    CAS  PubMed  Google Scholar 

  • A Hoffman E Grossman HR Keiser (1991) ArticleTitleIncreased plasma levels and blunted effects of brain natriuretic peptide in rats with congestive heart failure Am J Hypertens 4 597–601 Occurrence Handle1:CAS:528:DyaK3MXmtVCrsbg%3D Occurrence Handle1831369

    CAS  PubMed  Google Scholar 

  • B Jennett M Bond (1975) ArticleTitleAssessment of outcome after severe brain damage: a practical scale Lancet 1 480–484 Occurrence Handle1:STN:280:CSqC3MjptVU%3D Occurrence Handle46957

    CAS  PubMed  Google Scholar 

  • K Kuwahara Y Saito Y Ogawa et al. (1998) ArticleTitleEndothelin-1 and cardiotrophin-1 induce brain natriuretic peptide gene expression by distinct transcriptional mechanisms Cardiovasc Pharmacol 31 S354–S356 Occurrence Handle1:CAS:528:DyaK1cXjtFartrk%3D

    CAS  Google Scholar 

  • ER Levin DG Gardner WK Samson (1998) ArticleTitleNatriuretic peptides N Engl J Med 339 321–328 Occurrence Handle10.1056/NEJM199807303390507 Occurrence Handle1:CAS:528:DyaK1cXlsVOit7Y%3D Occurrence Handle9682046

    Article  CAS  PubMed  Google Scholar 

  • LF Marshall SB Marshall MR Klauber et al. (1992) ArticleTitleThe diagnosis of head injury requires a classification based on computed axial tomography J Neurotrauma 1 S287–S292

    Google Scholar 

  • MJ McGirt R Blessing SM Nimjee AH Friedman MJ Alexander DT Laskowitz JR Lynch (2004) ArticleTitleCorrelation of serum brain natriuretic peptide with hyponatremia and delayed ischemic neurological deficits after subarachnoid hemorrhage Neurosurgery 54 1369–1373 Occurrence Handle15157293

    PubMed  Google Scholar 

  • J Minamikawa H Kikuchi M Ishikawa et al. (1994) ArticleTitleThe effects of atrial natriuretic peptide on brain edema, intracranial pressure and cerebral energy metabolism in rat congenital hydrocephalus Acta Neurochir (Wien) 60S 104–106

    Google Scholar 

  • N Minamino M Aburaya S Ueda et al. (1998) ArticleTitleThe presence of brain natriuretic peptide of 12,000 daltons in porcine heart Biochem Biophys Res Commun 155 740–746

    Google Scholar 

  • K Morinaga S Hayashi Y Matsumoto et al. (1992) ArticleTitleA study of plasma atrial natriuretic peptide, antidiuretic hormone and aldosterone levels in a series of patients with intracranial disease and hyponatremia No Shinkei Geka 20 45–49 Occurrence Handle1:CAS:528:DyaK38XktVWlurk%3D Occurrence Handle1531380

    CAS  PubMed  Google Scholar 

  • K Morinaga S Hayashi Y Matsumoto et al. (1994) ArticleTitleTherapeutic effect of mineralocorticoid in patients with hyponatremia of central origin No To Shinkei 46 545–548 Occurrence Handle1:STN:280:ByuA2cjkvVM%3D Occurrence Handle8068436

    CAS  PubMed  Google Scholar 

  • GA Rosenberg EY Estrada (1995) ArticleTitleAtrial natriuretic peptide blocks hemorrhagic brain edema after 4-hour delay in rats Stroke 26 874–877 Occurrence Handle1:CAS:528:DyaK2MXlvFCqsLo%3D Occurrence Handle7740582

    CAS  PubMed  Google Scholar 

  • GE Sviri M Feinsod JF Soustiel (2000) ArticleTitleBrain natriuretic peptide and cerebral vasospasm in subarachnoid hemorrhage: clinical and TCD correlations Stroke 31 118–122 Occurrence Handle1:STN:280:DC%2BD3c%2FptlShsw%3D%3D Occurrence Handle10625725

    CAS  PubMed  Google Scholar 

  • GE Sviri B Shik B Raz et al. (2001) ArticleTitleBrain natriuretic peptide and cerebral vasospasm in subarachnoid hemorrhage Acta Neurochir (Wien) 77 41–43 Occurrence Handle1:STN:280:DC%2BD3Mrhs1GrsA%3D%3D

    CAS  Google Scholar 

  • G Tesdale B Jennett (1974) ArticleTitleAssessment of coma and impaired consciousness: practical scale Lancet 2 81–84

    Google Scholar 

  • M Tomida M Muraki K Uemura K Yamasaki (1998) ArticleTitlePlasma concentrations of brain natriuretic peptide in patients with subarachnoid hemorrhage Stroke 29 1584–1587 Occurrence Handle1:CAS:528:DyaK1cXlsVOmur8%3D Occurrence Handle9707197

    CAS  PubMed  Google Scholar 

  • T Tsubokawa Y Shiokawa H Kurita H Kaneko (2004) ArticleTitleHigh plasma concentration of brain natriuretic peptide in patients with ruptured anterior communicating artery aneurysm Neurol Res 26 893–896 Occurrence Handle10.1179/016164104225017776 Occurrence Handle1:CAS:528:DC%2BD2MXjvFWjtw%3D%3D Occurrence Handle15727273

    Article  CAS  PubMed  Google Scholar 

  • CM Wei DM Heublein MA Perrella et al. (1993) ArticleTitleNatriuretic peptide system in human heart failure Circulation 88 1004–1009 Occurrence Handle8353861

    PubMed  Google Scholar 

  • EFM Wijdicks WI Schievink JC Burnett (1997) ArticleTitleNatriuretic peptide system and endothelin in aneurysmal subarachnoid hemorrhage J Neurosurg 87 275–280 Occurrence Handle1:CAS:528:DyaK2sXls1Citr0%3D Occurrence Handle9254093

    CAS  PubMed  Google Scholar 

  • RD Zafonte NR Mann (1997) ArticleTitleCerebral salt wasting syndrome in brain injury patients: a potential cause of hyponatremia Arch Phys Med Rehabi 78 540–542 Occurrence Handle1:STN:280:ByiA3crhtVc%3D

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Rambam (Maimonides) Medical Center, Technion-Israel Institute of Technology, Haifa, Israel

    G. E. Sviri, J. F. Soustiel & M. Zaaroor

Authors
  1. G. E. Sviri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. F. Soustiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Zaaroor
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sviri, G., Soustiel, J. & Zaaroor, M. Alteration in brain natriuretic peptide (BNP) plasma concentration following severe traumatic brain injury. Acta Neurochir (Wien) 148, 529–533 (2006). https://doi.org/10.1007/s00701-005-0666-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-005-0666-4

Search

Navigation