Anterior Pituitary Function Following Traumatic Brain Injury

Moslem Shakeri, Firooz Salehpour, Mohammad Asghari, Javad Aghazadeh, Ata Mahdkhah, Farhad Mirzaei

Abstract


Background: Neuroendocrine dysfunction following traumatic brain injury is frequently missed because of absence of major symptoms. Thus, no appropriate management is done and it may delay the patient recovery. This study is aimed to clarify the frequency and pattern of anterior pituitary dysfunction following TBI.

Materials and Methods: Seventy patients, who were admitted to trauma center following TBI with GCS (Glasgow Coma Scale) of <12, were included. Patients were tested 6 months after injury for possible secretory abnormalities of anterior pituitary hormones. Basal level of target and pituitary trophic hormones were measured and dynamic test of stimulation with cosintropin and glucagons were done when needed.

Results: Forty one patients (58.6%) were suffered at least one hormonal secretory abnormality. The pattern and frequency of hormonal deficiencies were: gonadotropins (LH, FSH), 12.9%, ACTH, 12.9%, GH, 4.3%, and prolactin, 1.4%. There was no case with thyrotropin deficiency. Hyperprolactinemia was found to be present in 23 cases (31.5%).

Conclusion: Gonadotropin and ACTH deficiencies are among the most common dysfunctions of anterior pituitary gland after traumatic brain injury.


Keywords


Traumatic brain injury; Anterior pituitary hormone