Research Reports - Endocrine changes after pediatric traumatic brain injury

Pituitary. 2012 Sep;15(3):267-75

Rose SR, Auble BA

Traumatic brain injury (TBI) is a very common occurrence in childhood, and can
lead to devastating long term consequences. Recent research has focused on the
potential endocrine consequences of TBI in adults. The research in children is
less robust. This paper reviews current literature regarding TBI and possible
hypothalamic and pituitary deficiencies in childhood. Acute endocrine changes are
commonly found after TBI in pediatric patients, which can include changes in
hypothalamic-pituitary-adrenal axis and antidiuretic hormone production and
release. In the long term, both temporary and permanent alterations in pituitary
function have been found. About 30% of children have hypopituitarism up to
5 years after injury. Growth hormone deficiency and disturbances in puberty are
the most common, but children can also experience ACTH deficiency, diabetes
insipidus, central hypothyroidism, and elevated prolactin. Every hormonal axis
can be affected after TBI in children, although growth hormone deficiency and
alterations in puberty are the most common. Because transient and permanent
hypopituitarism is common after TBI, survivors should be screened serially for
possible endocrine disturbances. These children should undergo routine
surveillance at least 1 year after injury to ensure early detection of
deficiencies in hormonal production in order to permit normal growth and

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