Brain Neurorehabil.  2012 Sep;5(2):52-57. 10.12786/bn.2012.5.2.52.

Endocrinologic Complications after Traumatic Brain Injury

• Beom J
• Oh BM

• KMID: 2270740
• DOI: http://doi.org/10.12786/bn.2012.5.2.52

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.

Keyword

brain injuries; endocrine system diseases; hypopituitarism; rehabilitation

MeSH Terms

Adrenal Insufficiency
Brain Injuries
Diabetes Insipidus, Neurogenic
Diffuse Axonal Injury
Endocrine System Diseases
Estradiol
Growth Hormone
Humans
Hydrocortisone
Hyperprolactinemia
Hypogonadism
Hypopituitarism
Hypothyroidism
Insulin-Like Growth Factor I
Mass Screening
Osmolar Concentration
Physical Examination
Prolactin
Skull Base
Sodium
Testosterone
Thyroid Gland
Treatment Outcome
Estradiol
Growth Hormone
Hydrocortisone
Insulin-Like Growth Factor I
Prolactin
Sodium
Testosterone

Figure

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  Fig. 1 Hypothalamus and pituitary gland.

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  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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