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Cushing Triad

MedGen UID:
1718618
•Concept ID:
C5236069
•
Sign or Symptom

Definition

A group of signs that often occurs in response to increased intracranial pressure: hypertension, bradycardia, and irregular breathing. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVCushing Triad

Professional guidelines

PubMed

Nelson's syndrome: a review of the clinical manifestations, pathophysiology, and treatment strategies.
Patel J, Eloy JA, Liu JK
Neurosurg Focus 2015 Feb;38(2):E14. doi: 10.3171/2014.10.FOCUS14681. PMID: 25639316
Adrenocorticotropic hormone for the treatment of West Syndrome in children.
Shumiloff NA, Lam WM, Manasco KB
Ann Pharmacother 2013 May;47(5):744-54. Epub 2013 Apr 19 doi: 10.1345/aph.1R535. PMID: 23606552
Sir Victor Horsley's contributions to the study and treatment of gunshot wounds of the head.
Cybulski GR, Stone JL, Patel KJ
Neurosurgery 2008 Oct;63(4):808-11; discussion 811-2. doi: 10.1227/01.NEU.0000325732.58528.86. PMID: 18981893

Recent clinical studies

Etiology

Cortisol, Stress, and Disease-Bidirectional Associations; Role for Corticosteroid-Binding Globulin?
Lee JH, Meyer EJ, Nenke MA, Lightman SL, Torpy DJ
J Clin Endocrinol Metab 2024 Aug 13;109(9):2161-2172. doi: 10.1210/clinem/dgae412. PMID: 38941154
Characterizing and predicting the Nelson-Salassa syndrome.
Graffeo CS, Perry A, Carlstrom LP, Meyer FB, Atkinson JLD, Erickson D, Nippoldt TB, Young WF, Pollock BE, Van Gompel JJ
J Neurosurg 2017 Dec;127(6):1277-1287. Epub 2017 Jan 13 doi: 10.3171/2016.9.JNS161163. PMID: 28084914
Adverse effects of glucocorticoids: coagulopathy.
Coelho MC, Santos CV, Vieira Neto L, Gadelha MR
Eur J Endocrinol 2015 Oct;173(4):M11-21. Epub 2015 May 13 doi: 10.1530/EJE-15-0198. PMID: 25971647
Adrenocorticotropic hormone for the treatment of West Syndrome in children.
Shumiloff NA, Lam WM, Manasco KB
Ann Pharmacother 2013 May;47(5):744-54. Epub 2013 Apr 19 doi: 10.1345/aph.1R535. PMID: 23606552
McCune-Albright syndrome.
Dumitrescu CE, Collins MT
Orphanet J Rare Dis 2008 May 19;3:12. doi: 10.1186/1750-1172-3-12. PMID: 18489744Free PMC Article

Diagnosis

Cortisol, Stress, and Disease-Bidirectional Associations; Role for Corticosteroid-Binding Globulin?
Lee JH, Meyer EJ, Nenke MA, Lightman SL, Torpy DJ
J Clin Endocrinol Metab 2024 Aug 13;109(9):2161-2172. doi: 10.1210/clinem/dgae412. PMID: 38941154
Characterizing and predicting the Nelson-Salassa syndrome.
Graffeo CS, Perry A, Carlstrom LP, Meyer FB, Atkinson JLD, Erickson D, Nippoldt TB, Young WF, Pollock BE, Van Gompel JJ
J Neurosurg 2017 Dec;127(6):1277-1287. Epub 2017 Jan 13 doi: 10.3171/2016.9.JNS161163. PMID: 28084914
Nelson's syndrome: a review of the clinical manifestations, pathophysiology, and treatment strategies.
Patel J, Eloy JA, Liu JK
Neurosurg Focus 2015 Feb;38(2):E14. doi: 10.3171/2014.10.FOCUS14681. PMID: 25639316
McCune-Albright syndrome.
Dumitrescu CE, Collins MT
Orphanet J Rare Dis 2008 May 19;3:12. doi: 10.1186/1750-1172-3-12. PMID: 18489744Free PMC Article
Shaken baby syndrome: the quest for evidence.
Squier W
Dev Med Child Neurol 2008 Jan;50(1):10-4. doi: 10.1111/j.1469-8749.2007.02004.x. PMID: 18173622

Therapy

One Case of Pituitary Stalk Interruption Syndrome Associated with Liver Cirrhosis.
He H, Li DM
Endocr Metab Immune Disord Drug Targets 2023;23(9):1229-1234. doi: 10.2174/1871530323666230228110650. PMID: 36852803
Characterizing and predicting the Nelson-Salassa syndrome.
Graffeo CS, Perry A, Carlstrom LP, Meyer FB, Atkinson JLD, Erickson D, Nippoldt TB, Young WF, Pollock BE, Van Gompel JJ
J Neurosurg 2017 Dec;127(6):1277-1287. Epub 2017 Jan 13 doi: 10.3171/2016.9.JNS161163. PMID: 28084914
Adverse effects of glucocorticoids: coagulopathy.
Coelho MC, Santos CV, Vieira Neto L, Gadelha MR
Eur J Endocrinol 2015 Oct;173(4):M11-21. Epub 2015 May 13 doi: 10.1530/EJE-15-0198. PMID: 25971647
Nelson's syndrome: a review of the clinical manifestations, pathophysiology, and treatment strategies.
Patel J, Eloy JA, Liu JK
Neurosurg Focus 2015 Feb;38(2):E14. doi: 10.3171/2014.10.FOCUS14681. PMID: 25639316
Adrenocorticotropic hormone for the treatment of West Syndrome in children.
Shumiloff NA, Lam WM, Manasco KB
Ann Pharmacother 2013 May;47(5):744-54. Epub 2013 Apr 19 doi: 10.1345/aph.1R535. PMID: 23606552

Prognosis

Cortisol, Stress, and Disease-Bidirectional Associations; Role for Corticosteroid-Binding Globulin?
Lee JH, Meyer EJ, Nenke MA, Lightman SL, Torpy DJ
J Clin Endocrinol Metab 2024 Aug 13;109(9):2161-2172. doi: 10.1210/clinem/dgae412. PMID: 38941154
Prehospital clinical signs are a poor predictor of raised intracranial pressure following traumatic brain injury.
Ter Avest E, Taylor S, Wilson M, Lyon RL
Emerg Med J 2021 Jan;38(1):21-26. Epub 2020 Sep 18 doi: 10.1136/emermed-2020-209635. PMID: 32948620Free PMC Article
Characterizing and predicting the Nelson-Salassa syndrome.
Graffeo CS, Perry A, Carlstrom LP, Meyer FB, Atkinson JLD, Erickson D, Nippoldt TB, Young WF, Pollock BE, Van Gompel JJ
J Neurosurg 2017 Dec;127(6):1277-1287. Epub 2017 Jan 13 doi: 10.3171/2016.9.JNS161163. PMID: 28084914
A most unusual patient at the Massachusetts General Hospital.
Ruhnke GW, Warshaw AL
Ann Surg 2011 Dec;254(6):845-9. doi: 10.1097/SLA.0b013e31823a9a36. PMID: 22107737Free PMC Article
New genes and/or molecular pathways associated with adrenal hyperplasias and related adrenocortical tumors.
Stratakis CA
Mol Cell Endocrinol 2009 Mar 5;300(1-2):152-7. Epub 2008 Nov 21 doi: 10.1016/j.mce.2008.11.010. PMID: 19063937Free PMC Article

Clinical prediction guides

Cortisol, Stress, and Disease-Bidirectional Associations; Role for Corticosteroid-Binding Globulin?
Lee JH, Meyer EJ, Nenke MA, Lightman SL, Torpy DJ
J Clin Endocrinol Metab 2024 Aug 13;109(9):2161-2172. doi: 10.1210/clinem/dgae412. PMID: 38941154
An international multicenter survey reveals health care providers' knowledge gap in childhood central nervous system tumors.
Rajagopal R, Moreira DC, Faughnan L, Wang H, Naqvi S, Krull L, Vasquez L, Diaz-Coronado R, Terao M, Devidas M, Qaddoumi I
Eur J Pediatr 2023 Feb;182(2):557-565. Epub 2022 Nov 16 doi: 10.1007/s00431-022-04712-4. PMID: 36383283
Prehospital clinical signs are a poor predictor of raised intracranial pressure following traumatic brain injury.
Ter Avest E, Taylor S, Wilson M, Lyon RL
Emerg Med J 2021 Jan;38(1):21-26. Epub 2020 Sep 18 doi: 10.1136/emermed-2020-209635. PMID: 32948620Free PMC Article
Characterizing and predicting the Nelson-Salassa syndrome.
Graffeo CS, Perry A, Carlstrom LP, Meyer FB, Atkinson JLD, Erickson D, Nippoldt TB, Young WF, Pollock BE, Van Gompel JJ
J Neurosurg 2017 Dec;127(6):1277-1287. Epub 2017 Jan 13 doi: 10.3171/2016.9.JNS161163. PMID: 28084914
Adrenal cortical adenoma: the fourth component of the Carney triad and an association with subclinical Cushing syndrome.
Carney JA, Stratakis CA, Young WF Jr
Am J Surg Pathol 2013 Aug;37(8):1140-9. doi: 10.1097/PAS.0b013e318285f6a2. PMID: 23681078Free PMC Article

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