Research Reports - Neuroendocrine dysfunctions and their consequences following traumatic brain injury

Orv Hetil. 2012 Jun 17;153(24):927-33

Czirják S, Rácz K, Góth M

Posttraumatic hypopituitarism is of major public health importance because it is
more prevalent than previously thought. The prevalence of hypopituitarism in
children with traumatic brain injury is unknown. Most cases of posttraumatic
hypopituitarism remain undiagnosed and untreated in the clinical practice, and it
may contribute to the severe morbidity seen in patients with traumatic brain
injury. In the acute phase of brain injury, the diagnosis of adrenal
insufficiency should not be missed. Determination of morning serum cortisol
concentration is mandatory, because adrenal insufficiency can be life
threatening. Morning serum cortisol lower than 200 nmol/L strongly suggests
adrenal insufficiency. A complete hormonal investigation should be performed
after one year of the trauma. Isolated growth hormone deficiency is the most
common deficiency after traumatic brain injury. Sports-related chronic repetitive
head trauma (because of boxing, kickboxing, football and ice hockey) may also
result in hypopituitarism. Close co-operation between neurosurgeons,
endocrinologists, rehabilitation physicians and representatives of other
disciplines is important to provide better care for these patients.

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