Research Reports - Incidence of pituitary dysfunction following traumatic brain injury
Br J Neurosurg. 2015 Nov 26:1-5. [Epub ahead of print]
Alavi SA(1), Tan CL(1), Menon DK(2), Simpson HL(3), Hutchinson PJ(1).
Patients with traumatic brain injury (TBI) may develop pituitary dysfunction.
Although, there is now increasing awareness of and investigations into such
post-traumatic hypopituitarism (PTHP), the exact prevalence and incidence remain
uncertain. Here, we aim to identify the incidence of PTHP in a selected
population of TBI patients deemed at risk of PTHP at a regional neurosurgical
centre in the UK. A total of 105 patients have been assessed in two cohorts: (i)
58 patients in serial cohort and (ii) 47 patients in cross-sectional late cohort.
We found that in serial cohort, 10.3% (6/58) of TBI patients had abnormalities of
the pituitary-adrenal axis in the acute phase (Day 0-7 post injury). In
comparison, in cross-sectional late cohort, 21.3% (10/47) of the patients
developed dysfunction in at least one of their pituitary axes at 6 months or more
post-TBI, with hypogonadotrophic hypogonadism being the most common. Twenty-two
patients from these two cohorts had their growth hormone assessment at 12 months
or more post-TBI and 9.1% (2/22) were found to have growth hormone deficiency.
Our results suggest that PTHP is a common condition amongst sufferers of TBI, and
appropriate measures should be taken to detect and manage it.