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Abstract
The endocrinologic complications such as adrenal insufficiency and hypopituitarism are common after traumatic brain injury (TBI) portending poor rehabilitation outcome. Anterior pituitary dysfunction presents as hypothyroidism, hypogonadism, growth hormone deficiency, adrenal insufficiency and hyperprolactinemia, whereas posterior pituitary dysfunction includes syndrome of inappropriate antidiuretic hormone and central diabetes insipidus. Careful history taking and physical examination are essential to detect these abnormalities early. Laboratory tests such as serum/urine sodium and osmolality, thyroid hormone, testosterone, estradiol, cortisol, prolactin, growth hormone or IGF-1 are also necessary. Screening of endocrinologic functions is recommended especially in patients with moderate or severe TBI, skull base fracture or diffuse axonal injury 3 to 6 months after injury. Further studies are needed to reveal the effect of early correction of endocrinologic abnormality on long-term functional outcome.
Figures and Tables
Fig. 2
The prevalence of anterior hypopituitarism in survivors of traumatic brain injury.8 1: Lieberman et al,16 2: Aimaretti et al,17 3: Popovic et al,18 4: Leal-Cerro et al,19 5: Aimaretti et al,20 6A: Schneider et al (3 months after injury),21 6B: Schneider et al (12 months after injury),21 7A: Tanriverdi et al (24 hours after injury),22 7B: Tanriverdi et al (12 months after injury),22 8: Klose et al,23 GHD: Growth hormone deficiency, ACTHD: Adrenocorticotrophic hormone deficiency, GnTD: Gonadotropin deficiency, TSHD: Thyroid-stimulating hormone deficiency, PRL: Prolactin.
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