Predictors of anterior pituitary insufficiency after traumatic brain injury

Summary Background  Several studies have reported a high prevalence of hypopituitarism after traumatic brain injury (TBI). Risk stratification is a prerequisite for cost‐effective hormonal screening of these patients. However, it is still unclear which risk factors predispose patients to develop ant...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 2008-02, Vol.68 (2), p.206-212
Main Authors: Schneider, M., Schneider, H. J., Yassouridis, A., Saller, B., Von Rosen, F., Stalla, G. K.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Brain Injuries - blood
Brain Injuries - complications
Brain Injuries - diagnostic imaging
Brain Injuries - metabolism
Endocrinopathies
Estradiol - blood
Female
Follicle Stimulating Hormone - blood
Fundamental and applied biological sciences. Psychology
Humans
Hypopituitarism - blood
Hypopituitarism - diagnostic imaging
Hypopituitarism - etiology
Hypopituitarism - metabolism
Hypothalamus. Hypophysis. Epiphysis (diseases)
Injuries of the nervous system and the skull. Diseases due to physical agents
Insulin-Like Growth Factor I - metabolism
Luteinizing Hormone - blood
Male
Medical sciences
Middle Aged
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pituitary Hormones, Anterior - blood
Prolactin - blood
Prospective Studies
Radiography
Risk Factors
Testosterone - blood
Thyrotropin - blood
Thyroxine - blood
Traumas. Diseases due to physical agents
Triiodothyronine - blood
Vertebrates: endocrinology
Young Adult
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Summary:Summary Background  Several studies have reported a high prevalence of hypopituitarism after traumatic brain injury (TBI). Risk stratification is a prerequisite for cost‐effective hormonal screening of these patients. However, it is still unclear which risk factors predispose patients to develop anterior hypopituitarism after TBI. Objective  To assess clinical and radiological risk factors for post‐traumatic hypopituitarism. Patients and methods  Seventy‐eight consecutive patients (52 men, 26 women; mean age 36·0 years, range 18–65 years) with mild, moderate or severe TBI were studied. Endocrine and clinical parameters were assessed 3 and 12 months after TBI. Results  We found diffuse axonal injury, basal skull fracture and older age to be major risk factors of post‐traumatic hypopituitarism. Conclusions  We have defined specific risk factors for the development of post‐traumatic hypopituitarism that are consistent with pathophysiological considerations. These findings might help to identify at‐risk patients.
ISSN:0300-0664
1365-2265
DOI:10.1111/j.1365-2265.2007.03020.x