Autonomic dysfunction syndromes after acute brain injury

Courtney Takahashi, Holly E. Hinson, Ian J. Baguley*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

26 Citations (Scopus)


The central autonomic nervous system (CAN) is a multifaceted, richly connected neural network incorporating the hypothalamus, its descending tracts through the brainstem, the insular cortex and down into the spinal cord. All levels of the CAN are susceptible to injury following traumatic brain injury (TBI), whether from focal or diffuse injury. Focal injuries would be expected to produce localized damage to CAN control centers, whereas the effects of diffuse injuries are presumed to be more diverse and/or widely distributed.As the combination of focal and diffuse injury following TBI can vary widely from one individual to the next, the impact of focal injuries is best understood with reference to the focal ischemic stroke literature. Subarachnoid hemorrhage (SAH), a common complication following TBI, also has predictable effects on autonomic control that can be understood with reference to spontaneous SAH literature. Finally, paroxysmal sympathetic hyperactivity (PSH), a syndrome incorporating episodes of heightened sympathetic drive and motor overactivity following minor stimulation, is discussed as an example of what happens when central inhibitory control of spinal cord autonomics is impaired.

Original languageEnglish
Title of host publicationTraumatic brain injury
EditorsJordan Grafman, Andres M. Salazar
Place of PublicationAmsterdam
Number of pages13
ISBN (Electronic)9780444635211, 9780444635341
ISBN (Print)9780444528926
Publication statusPublished - 2015
Externally publishedYes

Publication series

NameHandbook of Clinical Neurology
Volume128 (3rd series)
ISSN (Print)0072-9752


  • central autonomic network
  • paroxysmal sympathetic hyperactivity
  • hyperadrenergic crisis
  • traumatic brain injury
  • subarachnoid hemorrhage
  • stroke


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