**2.3 Endocrine system, stress and metabolic responses**

Diabetes insipidus secondary to posterior pituitary infarction and lack of antidiuretic hormone results in electrolyte imbalance, hypovolemia, and circulatory instability. Thyroid hormonal changes and thyroid-stimulating hormone (TSH) levels show the typical picture of euthyroid sick syndrome. Temperature regulation in the hypothalamus is affected, manifesting with initial hyperthermia followed by hypothermia. Hypothermia, additionally worsened by peripheral vasodilatation, further aggravates acidosis and increases the risk for arrhythmias and cold-induced diuresis. Due to reduced insulin concentration and peripheral insulin resistance, hyperglycaemia is common [7, 12].
