在脑挫伤及头部外伤、硬膜下出血、高血压性颅内出血、脑栓塞等脑血管损害时,了解急性期脑损伤的程度,对诊断治疗以及判断预后是至关重要的。而脑CT 扫描等形态学检查和EEG、ABR(脑干听觉反应)、SEP(躯体感觉电位)等生理学的资料又难以取得,因此有将脑损伤的程度从代谢方面来观察的报告,从而测定肌磷酸激酶的同功酶、醛缩酶、儿茶酚胺、脑垂体激素等各种物质者不胜枚举,用来探讨其临床意义。作者过去发表过在头部外伤意识明显障碍的病例中受伤后的急性期有醛固酮增高的报告,且在脑血管损伤而有明显意识障碍的患者和硬膜下出血及高血压性脑出血危重病例中,也见到醛固酮升高。为了明确脑损伤急性期血中醛固酮升高的机制,测定了脑神经外科疾病急性期患者血中醛固酮、肾素活性、血浆钾及ACTH。对象及方法以神经外科急诊入院患者为对象,入院时血中醛固酮升高的有53例,其中高血压性脑出血7例,硬膜下出血13例,脑栓塞4例,头部外伤21例,抽搐发作 In brain contusion and head trauma, subdural hemorrhage, hypertensive intracranial hemorrhage, cerebral embolism and other cerebral vascular damage, to understand the extent of acute brain injury, diagnosis and treatment and prognosis is crucial. However, morphological tests such as brain CT scan and physiological data such as EEG, ABR (brainstem auditory reaction), and SEP (somatosensory potential) are difficult to obtain. Therefore, there is a report on the degree of brain damage observed from the perspective of metabolism to determine Creatine kinase isoenzyme, aldolase, catecholamines, pituitary hormones and other substances are numerous to explore its clinical significance. The authors have previously reported reports of increased aldosterone in the acute phase after injury in patients with significant impairment of head traumas and in patients with marked impairment of cerebrovascular disease and those with subdural and hypertensive intracerebral hemorrhage Aldosterone is also seen to rise. In order to clarify the mechanism of aldosterone increase in acute phase of brain injury, aldosterone, renin activity, plasma potassium and ACTH were measured in patients with acute neurosurgical disease. Subjects and Methods Patients admitted to the emergency department of neurosurgery were enrolled in this study. There were 53 cases of elevated aldosterone in admission, including 7 cases of hypertensive intracerebral hemorrhage, 13 cases of subdural hemorrhage, 4 cases of cerebral embolism, 21 cases of head trauma , Seizures