April 11, 1980

Hyperadrenergic State After Trauma to the Neuroaxis

Author Affiliations

From the Departments of Medicine (Drs Wortsman, Burns, and Couch) and Surgery (Dr Van Beek), Southern Illinois University School of Medicine, Springfield.

JAMA. 1980;243(14):1459-1460. doi:10.1001/jama.1980.03300400043030

INCREASED catecholamine excretion rates have been reported in pheochromocytoma, congestive heart failure, myocardial infarction, cerebrovascular accident,1 and CNS trauma.2 This article describes a patient who had persistent hypertension associated with elevated catecholamine excretion rates subsequent to trauma to the CNS. This pheochromocytomalike syndrome may be a common complication of trauma to the CNS.

Report of a Case  A 40-year-old man was hospitalized after being involved in a high-speed boating accident. At the time of the accident, the patient lost consciousness for one to two minutes; however, there were no external signs of injury to the head. On initial examination, the patient was in no acute distress. Blood pressure was 140/90 mm Hg while he was supine, and the pulse rate was 90 beats per minute and regular. There was complete paralysis of the right arm, with swelling of the right cervical region extending down to the arm. Roentgenograms