Post Head Injury Autonomic Complications Workup

Updated: Jan 20, 2021
  • Author: Stephen Kishner, MD, MHA; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Laboratory Studies

Appropriate lab studies include the following:

  • Complete blood count (CBC) - To reveal potential infection (Elevated white blood cell and/or platelet counts may signal infection.)

  • Blood cultures - To rule out sepsis

  • Sputum cultures - To rule out pneumonia

  • Urine cultures and urinalysis - To rule out urinary tract infection

  • Sputum Gram stain - To rule out infection

  • Plasma catecholamine levels - May be of interest acutely but are not required for the diagnosis

  • Thyroid panel - To rule out thyroid storm

  • Random chemistry panel - To rule out neuroleptic malignant syndrome

  • Plasma creatine kinase and troponin levels - To rule out acute MI, neuroleptic malignant syndrome, and serotonin syndrome


Imaging Studies

Appropriate imaging studies include the following:

  • Chest radiograph - To rule out pneumonia and atelectasis

  • Duplex ultrasonogram - To rule out DVT

  • Electrocardiogram (ECG) - To rule out MI

  • Head computed tomography (CT) or magnetic resonance imaging (MRI) scan - To rule out abscess, encephalitis, or hydrocephalus



Lumbar puncture may be performed to rule out meningitis.


Other Tests

A multicenter study by Lucca et al indicated that in acquired brain injury patients with paroxysmal sympathetic hyperactivity who undergo neurorehabilitation, clinical factors that most influence outcome can be evaluated via the PSH-Assessment Measure score at baseline and 4 months post event, the neurologic diagnosis, and the Coma Recovery Scale-Revised (CRS-R) and Rancho Los Amigos Scale (RLAS) scores at baseline. [11]