Anterior hypopituitarism following traumatic brain injury

Randall Urban, P. Harris, Brent Masel

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Primary Objectives. To review evidence that there exists a substantial sub-population of patients with endocrine disorders as a result of traumatic brain injury (TBI) and to underscore the importance of screening patients with TBI considered most at risk for hypopituitarism with the goal of attaining beneficial effects in terms of morbidity and quality of life. Design and methods. Reviewed recent literature regarding the frequency of TBI-induced hypopituitarism. Main outcomes and results. Studies by Kelly DF, Gaw Gonzalo IT, Cohan P, et al. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: A preliminary report. Journal of Neurosurgery 2000;93:743-751, Lieberman SA, Oberoi AL, Gilkison CR, et al. Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury. Journal of Clinical Endocrinology and Metabolism 2001;86:2752-2756 and Aimaretti G, Ambrosio MR, Di Somma C, et al. Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism. Screening study at 3 months after the brain injury, In press., found that about one-half to one-third of patients with TBI had anterior pituitary hormone deficiencies, including growth hormone (GH) deficiency in 15-21%, and subtle deficiencies in thyroid, adrenal and gonadal axes. One or more hormonal deficiencies produce diverse physical and psychological symptoms that may mimic symptoms attributed to brain trauma and may impair rehabilitation. A more general concern is the fact that hypopituitarism increases the risk of significant morbidity (e.g. ischaemic heart disease) and mortality (shortened life span). Conclusions. To attain maximal improvement in mental and physical functioning as well as in quality of life for victims of TBI, it is crucial that anterior pituitary hormonal function be assessed. Appropriate hormone replacement therapy for those patients with both TBI and TBI-induced pituitary function impairment could, for the first time, allow treatment and correction of underlying causes of TBI sequelae rather than merely symptomatic treatment.

Original languageEnglish (US)
Pages (from-to)349-358
Number of pages10
JournalBrain Injury
Volume19
Issue number5
DOIs
StatePublished - May 2005

Fingerprint

Hypopituitarism
Traumatic Brain Hemorrhage
Traumatic Brain Injury
Traumatic Subarachnoid Hemorrhage
Quality of Life
Anterior Pituitary Hormones
Morbidity
Endocrinology
Hormone Replacement Therapy
Neurosurgery
Subarachnoid Hemorrhage
Brain Injuries
Growth Hormone
Myocardial Ischemia
Thyroid Gland
Rehabilitation

Keywords

  • Growth hormone deficiency
  • Head trauma
  • Hypopituitarism
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Anterior hypopituitarism following traumatic brain injury. / Urban, Randall; Harris, P.; Masel, Brent.

In: Brain Injury, Vol. 19, No. 5, 05.2005, p. 349-358.

Research output: Contribution to journalArticle

Urban, Randall ; Harris, P. ; Masel, Brent. / Anterior hypopituitarism following traumatic brain injury. In: Brain Injury. 2005 ; Vol. 19, No. 5. pp. 349-358.
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