Abstract: Objective  To investigate the alterations of serum cortisol (COR), corticosteroid-binding-globulin (CBG) and free cortisol (FC) after acute traumatic brain injury (TBI) emergency operation, and to find out the influence of emergency craniotomy to COR. Methods  All patients were randomly selected, 29 of which were treated conservatively (conservative group) and 26 were treated surgically (surgical group). COR and CBG were measured; FC was calculated from COR and CBG. COR levels were compared between conservative and surgical groups, and between preoperation and postoperation in surgical group. Results  After acute TBI, the preoperation COR level in surgical group was higher than that in conservative group (P＜0.05); in surgical group, COR level decreased after operation (P＜0.05); COR was of the same level between two groups after treatment (P＞0.05). FC levels were relatively stable in different conditions (P＞0.05). Conclusion  Following acute TBI, emergency operation can alleviate stress reaction to keep the stability of neuroendocrine. Bio-active FC preserves relatively stable in perioperative period to maintain normal physiological function.

Key words: Corticosteroid-binding globulin, Traumatic brain injury, Free cortisol, Cortisol