Research Reports - Pituitary function within the first year after traumatic brain injury

J Endocrinol Invest. 2016 Sep 26. [Epub ahead of print]

Tölli A(1), Borg J(2), Bellander BM(3), Johansson F(4), Höybye C(5,)(6).

PURPOSE: Reports on long-term variations in pituitary function after traumatic
brain injury (TBI) and subarachnoid haemorrhage (SAH) diverge. The aim of the
current study was to evaluate the prevalence and changes in pituitary function
during the first year after moderate and severe TBI and SAH and to explore the
relation between pituitary function and injury variables.
METHODS: Adults with moderate and severe TBI or SAH were evaluated at 10 days, 3,
6 and 12 months post-injury/illness. Demographic, clinical, radiological,
laboratory, including hormonal data were collected.
RESULTS: A total of 91 adults, 56 (15 women/41 men) with TBI and 35 (27 women/8
men) with SAH were included. Perturbations in pituitary function were frequent
early after the event but declined during the first year of follow-up. The most
frequent deficiency was hypogonadotrope hypogonadism which was seen in
approximately 25 % of the patients. Most of the variations were transient and
without clinical significance. At 12 months, two patients were on replacement
with hydrocortisone, four men on testosterone and one man on replacement with
growth hormone. No relations were seen between hormonal levels and injury
CONCLUSIONS: Perturbations in pituitary function continue to occur during the
first year after TBI and SAH, but only a few patients need replacement therapy.
Our study could not identify a marker of increased risk of pituitary dysfunction
that could guide routine screening. However, data demonstrate the need for
systematic follow-up of pituitary function after moderate or severe TBI or SAH. 

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