Pituitary insufficiency after traumatic brain injury |
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| Authors: | Dorothee Wachter Katja Gündling Matthias F Oertel Hilmar Stracke Dieter-Karsten Böker |
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| Affiliation: | 1. Department of Neurosurgery, University Hospital, Giessen-Marburg, Klinikstrasse 29, 35385 Giessen, Germany;2. Department of Endocrinology, University Hospital, Giessen-Marburg, Giessen, Germany;1. Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, United Kingdom;2. Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom;3. Department of Surgery and Cancer, St. Mary''s Hospital, London, United Kingdom;4. Department of Gastroenterology, St. Mary''s Hospital, London, United Kingdom;1. Department of Neurosurgery, National Hospital Organization Kumamoto Medical Center, 1-5, Ninomaru, Chuo-ku, Kumamoto 860-0008, Japan;2. Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University School of Medicine, 1-1-1, Honjo, Kumamoto, Kumamoto 861-8556, Japan;1. Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts;3. Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;4. Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;6. Decision Support, Beth Israel Deaconess Medical Center, Boston, Massachusetts;1. Medical Physics Unit, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy;2. Nuclear Medicine Unit, San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy;1. University of Florida College of Medicine—Jacksonville, Jacksonville, FL;2. Division of Cardiology, Department of Medicine, Gyeongsang National University Hospital, Jinju, Korea;2. Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands;3. Division of Image Processing, Department of Radiology, LUMC, Leiden, The Netherlands;4. Department of Medical Statistics, LUMC, Leiden, The Netherlands;6. Department of Clinical Epidemiology, LUMC, Leiden, The Netherlands |
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| Abstract: | After traumatic brain injury (TBI), patients present with psychological disorders that may be explained by post-traumatic pituitary insufficiency (PI). The goal of this study was to determine the relationship between hypopituitarism, neuropsychological changes and findings on CT scans after TBI. Hospital charts of 55 TBI patients were screened for age, Glasgow Coma Scale (GSC) score, hypoxia or hypotension. The first two CT scans were analyzed for hemorrhagic lesions. Basal levels of the following hormones were recorded: cortisol, prolactin, estradiol, testosterone, insulin-like growth factor 1 and free thyroxine. Hormonal stimulation tests were performed either if the basal hormone screening revealed an abnormality or if the patient answered “yes” to at least one question in the non-evaluated neuropsychological questionnaire. Overall, 14 out of 55 patients (25.4%) presented with PI; one of them with two hormonal deficits. Growth hormone deficit, hypothyroidism and hypocortisolism were found in one, one and two patients, respectively. Neuropsychological complaints were present in 67% of the patients and were associated with intracerebral hemorrhagic lesions and not PI. Neuropsychological complaints after TBI are more frequent than PI. Brain tissue damage is most important than PI in the development of psychological changes after TBI. |
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